Myopic Laser-Assisted Subepithelial Keratectomy (LASEK) outcomes using three different excimer laser platforms: a retrospective observational study.

BACKGROUND: To compare the visual and refractive outcomes after myopic LASEK using three different excimer lasers and standardized surgical and mitomycin C (MMC) application protocols. METHODS: In this retrospective, observational cohort study, we examined 122 eyes treated with Allegretto, 135 eyes treated with Esiris and 137 eyes treated with Technolas excimer lasers. All eyes were treated under the same surgical protocol, and a standardized MMC dosage was used. The three groups were refraction-matched, and both visual and refractive outcomes were evaluated at 1 and 7 days and 1 and 3 months after surgery. RESULTS: At 3 months postsurgery, Allegretto provided significantly better outcomes than Esiris and Technolas in terms of postoperative uncorrected distance visual acuity (UDVA) (1.11 ± 0.2 vs 1.01 ± 0.2 vs 0.98 ± 0.2) (P = 0.0001), corrected distance visual acuity (CDVA) (1.13 ± 0.2 vs 1.10 ± 0.1 vs 1.04 ± 0.2) (P = 0.0001), residual sphere (- 0.01 ± 0.2 vs + 0.29 ± 0.7 vs + 0.27 ± 0.6) (P = 0.0001), and efficacy index (0.99 ± 0.2 vs 0.90 ± 0.2 vs 0.91 ± 0.2) (P = 0.0004). CONCLUSIONS: We found slightly better visual and refractive outcomes in the Allegretto group at 3 months post-op after LASEK with MMC to correct myopia.

Retinal nerve fiber layer thickness after laser-assisted subepithelial keratomileusis and femtosecond LASIK: a prospective observational cohort study.

PURPOSE: Based on the assumption that high levels of intraocular pressure (IOP) during femtosecond laser-assisted in situ keratomileusis (FS-LASIK) may compromise the retinal nerve fiber layer (RNFL), newer femtosecond platforms that operate without causing significant IOP elevation have been developed in recent years. However, this assumption has not been adequately tested. The aim of the current study was to evaluate possible changes in RFNL thickness in nonglaucomatous myopic patients undergoing FS-LASIK using the 60 KHz IntraLase® device that significantly elevates the IOP for an appreciable period of time vs an advanced surface ablation technique (laser-assisted subepithelial keratomileusis, LASEK) that does not induce any IOP elevation. METHODS: This was a prospective, observational, controlled cohort study. One randomly selected eye of 114 consecutive eligible patients was analyzed. Inclusion criteria were myopia up to -6.00 diopters and astigmatism up to -2.00 diopters. As clinically indicated, 50 patients underwent LASEK and 64 underwent FS-LASIK. The RNFL thickness was determined with a spectral-domain optical coherence tomography device preoperatively and 3 months postoperatively by the same masked observer. RESULTS: There was no significant difference in preoperative refractive error, age, or sex between the groups. Preoperatively, central corneal thickness was significantly lower in the LASEK group (529.1±36.1 vs 562.4±31.6 µm, P=0.001). For the LASEK group, there was no significant difference between preoperative and postoperative RNFL thickness in the studied sectors (superior-temporal, temporal, inferior-temporal, average). For the FS-LASIK group, compared to preoperative RNFL measures, statistically significant thicker postoperative values were found for the average RNFL (mean difference: 0.67 µm, 0.7% increase, P=0.008) and the inferior-temporal sector (mean difference: 0.92 µm, 0.6% increase, P=0.02). CONCLUSION: LASIK with a femtosecond platform that induces high intraoperative IOP did not cause RNFL thinning. The observed differences between preoperative and postoperative values are below the axial resolution limit of optical coherence tomography devices.

Visual acuity after laser in situ keratomileusis to correct high astigmatism in adults with meridional amblyopia.

PURPOSE: To analyze the effect of laser in situ keratomileusis to correct high myopic astigmatism in patients with suboptimal best spectacle-corrected visual acuity (BSCVA). DESIGN: Retrospective, interventional series of consecutive cases. SETTING: Vissum Madrid, Madrid, Spain. PATIENTS: Two hundred five eyes of consecutive patients with suboptimal BSCVA and high myopic astigmatism of -3 diopters or more. INTERVENTION: Laser in situ keratomileusis surgery. MAIN OUTCOME MEASURES: BSCVA. RESULTS: The BSCVA (decimal Snellen fraction notation) improved significantly (P = .0001) from a mean preoperative 0.77 ± 0.18 (range, 0.05 to 0.90) to 0.81 ± 0.19 (range, 0.05 to 1.25) 3 months after surgery. The mean change in lines of BSCVA (decimal Snellen fraction notation) was 0.04 ± 0.11 (range, -0.25 to 0.4). A significant inverse relationship (P = .001) was found between the preoperative BSCVA and the improvement in BSCVA. CONCLUSIONS: In eyes with high myopic astigmatism and suboptimal preoperative BSCVA, laser in situ keratomileusis may result in a significant improvement in BSCVA.