Patient and surgeon experience during laser in situ keratomileusis using 2 femtosecond laser systems.
OBJECTIVE
To describe the subjective experience of patients and surgeons during laser in situ keratomileusis (LASIK) using the Intralase 60 kHz or the Visumax 500 kHz femtosecond laser.


METHODS
Singapore National Eye Centre, Singapore.


METHODS
Prospective randomized clinical study.


METHODS
In myopic patients, LASIK was performed with the corneal flap created using the 60 kHz laser in 1 eye and the 500 kHz laser in the contralateral eye. Postoperatively, patients completed a standardized validated questionnaire about their subjective intraoperative experiences (eg, light perception, pain, fear). Surgeons reported their intraoperative experiences and preferences.


RESULTS
Loss of light perception occurred in 50.0% of 60 kHz laser cases and 0% of 500 kHz laser cases during docking and in 63.0% and 0% of cases, respectively, during laser flap creation (P < .0001). The mean pain score with the 60 kHz laser was significantly higher during docking (P < .0001) but not during laser flap cutting (P = .006). Subconjunctival hemorrhage occurred in 67.4% of eyes with the 60 kHz laser and in 2.2% of eyes with the 500 kHz laser (P < .0001). The 500 kHz laser was preferred by 78.3% of patients, while 21.7% preferred the 60 kHz laser (P < .0001). The surgeons preferred the 60 kHz laser in 50.0% of cases and the 500 kHz laser in 8.7% (P < .0001); 41.3% had no preference.


CONCLUSIONS
Patients preferred surgery with the 500 kHz laser with no loss of light perception, less pain, less fear, and less subconjunctival hemorrhage. Surgeons preferred the 60 kHz laser.
From the Singapore National Eye Centre (Hall, Rosman, Chan, Tan, Mehta), the Singapore Eye Research Institute (Rosman, Tan, Mehta), the Yong Loo Lin School of Medicine (Tan), National University of Singapore, and the Department of Clinical Sciences (Mehta), Duke-NUS Graduate Medical School, Singapore.
Reece C
RC
Hall
From the Singapore National Eye Centre (Hall, Rosman, Chan, Tan, Mehta), the Singapore Eye Research Institute (Rosman, Tan, Mehta), the Yong Loo Lin School of Medicine (Tan), National University of Singapore, and the Department of Clinical Sciences (Mehta), Duke-NUS Graduate Medical School, Singapore.
Mohamad
M
Rosman
From the Singapore National Eye Centre (Hall, Rosman, Chan, Tan, Mehta), the Singapore Eye Research Institute (Rosman, Tan, Mehta), the Yong Loo Lin School of Medicine (Tan), National University of Singapore, and the Department of Clinical Sciences (Mehta), Duke-NUS Graduate Medical School, Singapore.
Cordelia
C
Chan
From the Singapore National Eye Centre (Hall, Rosman, Chan, Tan, Mehta), the Singapore Eye Research Institute (Rosman, Tan, Mehta), the Yong Loo Lin School of Medicine (Tan), National University of Singapore, and the Department of Clinical Sciences (Mehta), Duke-NUS Graduate Medical School, Singapore.
Donald T H
DT
Tan
From the Singapore National Eye Centre (Hall, Rosman, Chan, Tan, Mehta), the Singapore Eye Research Institute (Rosman, Tan, Mehta), the Yong Loo Lin School of Medicine (Tan), National University of Singapore, and the Department of Clinical Sciences (Mehta), Duke-NUS Graduate Medical School, Singapore. Electronic address: jodmehta@gmail.com.
Jodhbir S
JS
Mehta
D000328:Adult; D003319:Corneal Stroma / Q000601:surgery*; D005260:Female; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000295:instrumentation* / Q000379:methods; D054018:Lasers, Excimer / Q000627:therapeutic use*; D008297:Male; D009216:Myopia / Q000503:physiopathology / Q000601:surgery*; D009885:Ophthalmology; D057240:Patient Preference / Q000523:psychology*; D010820:Physicians / Q000523:psychology*; D011446:Prospective Studies; D012029:Refraction, Ocular / Q000502:physiology; D013524:Surgical Flaps; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult