V 738
Bilateral simultaneous or sequential LASIKT. Pahlitzsch, S. Pahlitzsch
Introduction: With increasing LASIK frequency more and more patients ask for bilateral simultaneous surgery. Most surgeons treat sequentially with a distance of at least one day. Since the simultaneous treatment offers advantages for the surgeon and the patient and same-day surgery is more convenient we have examined the safety of the bilateral simultaneous intervention.
Method: The patients could decide in favor of one of the two groups. In group A both eyes were treated simultaneously (n= 64 patients, 128 eyes). In group B 57 patients = 114 eyes were treated bilateral sequentially in the distance of at least 7 days at the second eye. Only healthy myopes were treated. LASIK was done with the MEL 70 G Scan and the Hansatome Keratome. Only myopes with a refractive error between -1,0 to -6,5 sph. and a maximum astigmatism of -1,5 cyl.dptr. became treated. After the LASIK procedure treatment was carried out with Floxal AT 4 days postop..< /FONT >
Results: In group A 4 times folds appeared in the flap, which didn't influence the visual outcome. 4x an Interstitielle diffuse Keratitis appeared with 1 patient at both eyes in the first days postop.. All 4 eyes healed under local therapy within few days. Only 1 patient lost one-sidedly BCVA (praeop. 1.0, postop. 0,6). A fine central fold was seen in the flap. Folds appeared in group B at 4 eyes, which didn't influence visual outcome. 2 eyes showed a short early interstitielle diffuse Keratitis. 1 eye lost BCVA (praeop. 0,8, postop. 0,5). Big folds were seen in the flap. 1 heavy Conjunctivitis Sicca with considerable cornea participation was treated with panthenol oinment over a longer time period. All patients in both groups, except the 2 eyes mentioned, reached their präop. BCVA.
Summary: Complications appeared in each of the two groups in almost same frequency. In agreement with Gimbel et al. bilateral simultaneous LASIK is as safe as bilateral sequential LASIK in the range of -1,0 to - 6,5 dptr.. If there is any doubt about the result of the first eye Lasik procedure the treatment of the partner eye should be refrained. The rest risk of bilateral infection is still present.
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