title: Femtosecond laser-assisted sub-Bowman keratomileusis versus laser-assisted subepithelial keratomileusis to correct myopic astigmatism.
abstract: OBJECTIVE
  To compare femtosecond laser-assisted sub-Bowman keratomileusis (FSBK) versus laser-assisted subepithelial keratomileusis (LASEK) to correct moderate to high myopic astigmatism.
  
  
  METHODS
  Retrospective, nonrandomized, interventional, comparative case series. A total of eight hundred and fifty-two eyes with myopic astigmatism of -1.5 diopters (D) or higher were included in the study. We compared 427 eyes treated with FSBK versus 425 eyes treated with LASEK with or without mitomycin C. Visual and refractive results were evaluated 1 day, 1 week, 3 and 6 months postoperatively.
  
  
  RESULTS
  Six months postoperatively, the residual spherical defect was slightly but significantly higher in the LASEK group (+0.15±0.62D) than in the FSBK group (+0.09±0.35D) (P=0.05). The postoperative residual astigmatism was also slightly but significantly higher in the LASEK group (-0.38±0.52D) than in the FSBK group (-0.26±0.45D) (P=0.0005). No significant differences were found in the efficacy (0.98±0.17 versus 0.98±0.36, P=0.6) and safety indexes (1.04±0.16 versus 1.05±0.37, P=0.1) between FSBK and LASEK. The enhancement rate was significantly higher in the FSBK group (22.6%) than in the LASEK group (15.5%) (P=0.01).
  
  
  CONCLUSIONS
  Both FSBK and LASEK are safe and effective procedures to correct moderate to high myopic astigmatism. Slightly better visual and refractive results were observed in FSBK-treated eyes in a 6-month follow-up.
authors.affiliation: Clínica Rementería, C/Almagro 36, 28010 Madrid, Spain; Hospital Universitario "Príncipe de Asturias," University of Alcalá, Carretera de meco s/n, Alcalá de Henares, Madrid, Spain. Electronic address: juangros@gmail.com.
authors.forename: Juan
authors.initials: J
authors.lastname: Gros-Otero
authors.affiliation: Clínica Rementería, C/Almagro 36, 28010 Madrid, Spain; Clínica Novovisión, C/Castellana 54, 28046 Madrid, Spain.
authors.forename: Montserrat
authors.initials: M
authors.lastname: Garcia-Gonzalez
authors.affiliation: Hospital Universitario "Príncipe de Asturias," University of Alcalá, Carretera de meco s/n, Alcalá de Henares, Madrid, Spain; Clínica Novovisión, C/Castellana 54, 28046 Madrid, Spain.
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Teus
authors.affiliation: Vissum Madrid, C/Santa Hortensia, 58, 28002 Madrid, Spain.
authors.forename: MariLuz
authors.initials: M
authors.lastname: Iglesias-Iglesias
authors.affiliation: Vissum Madrid, C/Santa Hortensia, 58, 28002 Madrid, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Gimenez-Vallejo
mesh_terms: D000293:Adolescent; D000328:Adult; D001251:Astigmatism / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D003315:Cornea / Q000601:surgery*; D005260:Female; D006801:Humans; D049008:Keratectomy, Subepithelial, Laser-Assisted / Q000379:methods*; D020731:Keratomileusis, Laser In Situ / Q000379:methods*; D054018:Lasers, Excimer / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D012029:Refraction, Ocular / Q000502:physiology*; D012189:Retrospective Studies; D014792:Visual Acuity; D055815:Young Adult
keywords: Astigmatismo miópico; FSBK; LASEK; Myopic astigmatism