laser in situ keratomileusis versus laser assisted subepithelial keratectomy for the correction of low to moderate myopia and astigmatism

purpose : to compare the visual and refractive outcomes of laser in situ keratomileusis (lasik) versus laser assisted subepithelial keratectomy (lasek) in the treatment of low to moderate myopia and astigmatism methods : a retrospective comparative case series study comprised 2,474 eyes of patients with manifest refraction spherical component lower than -5.00 diopters (d) and cylinder components lower than -3.00 d were assigned to 2 groups: 1,238 eyes were treated with lasik and 1,236 eyes with lasek. uncorrected visual acuity (ucva), best spectacle corrected visual acuity (bscva), remaining refractive error, and complications were evaluated at 1 week, 2, 6, 12, and 36 months postoperation. results : preoperatively the mean refractive spherical equivalent (mrse) was -3.42 d±1.01 (sd) in lasik group and -3.36 d±1.01 (sd) in lasek group, at 2 months it was -0.12 d±0.279 and -0.37 d±0.341, at 36 months postoperation in lasik group it was -0.06 d±0.25 and in lasek group it was -0.14±0.28 d, respectively. at 2 and 36 months, ucva was 20/20 in 91.5% and 77.8% in lasik group and, 94.7% and 90.9% in lasek group, respectively. at 2 and 36 months, 95.4% and 78.7% in lasik, 97.3% and 94.2% in lasek group respectively were within ±0.5 d of emmetropia. diffuse lamellar keratitis (dlk) in 5.9% and corneal ectasia in 1.05% of eyes (n=13) in the lasik group and corneal haze in 10.6% (n=131) eyes in the lasek group were seen. conclusion : both lasik and lasek were safe and effectively treated eyes with low to moderate myopia and astigmatism. lasek provided superior results in visual outcomes.   iranian journal of ophthalmology 201224(4):31-39 © 2012 by the iranian society of ophthalmology