Postoperative Pain and Epithelial Wound Healing in Epi-LASIK With and Without an Epithelial Sheet Preservation

ABSTRACT

PURPOSE: To investigate the influence of preservation of an epithelial sheet in Epi-LASIK on postoperative pain and epithelial wound healing time. METHODS: This prospective study included 34 eyes of 17 patients with myopia who received Epi-LASIK. An epithelial flap was created using the epikeratome (Centurion SES, Norwood Abbey EyeCare, Australia). After the stroma was ablated using the MEL 80 (Carl Zeiss Meditec. Germany) excimer laser, the epithelial sheet was replaced on the stromal bed in one randomly selected eye of each patient, and removed in the contralateral eye. The pain scores at postoperative day 0, 1, 2, 5 and the numbers of days for the complete epithelial wound healing were compared between the sheet-preserved and the sheet-removed eyes. At 1 month postoperative, uncorrected visual acuity (UCVA), refractive error and corneal haze were also compared. RESULTS: Pain scores on the day of operation were lower in sheet-preserved group and statistically significant (p=0.01). On postoperative day 1, 2, and 5, pain scores did not reach statistical significance (p=0.24, 0.08, 0.56, respectively). The mean epithelial healing time was 4.88+/-0.93 days for the flap-preserved eyes and 4.29+/-0.77 days for the flap-removed eyes, which showed statistical significance (p=0.01). No significant difference was noted between the 2 groups for mean UCVA, corneal haze and refractive error at 1 month postoperative. CONCLUSIONS: A preserved epithelial sheet reduced early postoperative pain but did not accelerate epithelial wound-healing rate.