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Impressum
Lasek /laser epithelial keratomileusis/- one year clinical results
Autrata R.
Department of Ophthalmology, University Hospital, Brno , Czech Republic
Objective: To assess clinical resuslts of a new technique in excimer
laser surgery involving raising and replacing of the epithelial flap versus
conventional PRK technique.
Methods: A prospective , comparative study was performed in 164
eyes of 82 patients who underwent PRK for correction of myopia and myopic
astigmatism. The preoperative mean spherical equivalent /MSE/ was -4.86
+- 3.07 D / range -1.75 to-7.5 D/. All the ezes were divided into two
groups. At group A was the first eye treated by PRK with epithelial debridement,
at group B the second eye of each patient was operated by LASEK. An epithelial
flap with superior hinge was prepared and rolled up. Then photoablation
was performed and the flap rolled back over the stromal ablation. Laser
sysem /Nidek EC 5000/ parameters and nomograms were the same in both groups.
Postoperative pain level , visual recovery,complications, visual acuity/
/UCVA, BCVA/ and refractive outcome were evaluated and compared in both
groups.
Results: The preoperative MSE was -4.86 +-3.07 D with no significant
difference between both groups.The postoperative MSE -0.16 +-0.54D in
A group and -0.29 +- 0.41D in B group. There was no statistically significant
difference bettwen A and B group in postoperative refraction at one year
postoperatively. The mean decimal UCVA at one week postoperatively was
0.65+-0.16 in A group and 0.84 +-0.19 in B /lasek/ group of eyes. There
was no line lost of BCVA at all eyes. The mean pain level was significantly
lower during the first and the second postoperative days in B group /p<0.05/,
it was evaluated bz subjective questionnare / grade 0 to 4 of pain/. the
corneal haze level was lower in the flap group B at 0.26 compared to 0.41
in the eyes with conventional PRK. This difference was also statistically
significant / p<0.05/.
Conclusion: As compared to conventional PRK a new technique with
epithelial flap replacement after photoablation provides significantly
quicker visual recovery and refractive stability , eliminates post PRK
pain and reduces the haze level.