PRK vs LASEK vs Epi-LASIK: a comparison of corneal haze, postoperative pain and visual recovery in moderate to high myopia.

INTRODUCTION The field of refractive surgery continues to evolve amid continued concerns as to which surgical technique minimizes the risk of inducing ectasia. PURPOSE To compare clinical outcomes between PRK, LASEK and Epi-LASIK in moderately to highly myopic eyes (-4.00 D to -8.00 D). MATERIALS AND METHODS A retrospective chart review of 100 PRK eyes, 100 LASEK eyes (with alcohol) and 97 Epi-LASIK eyes was performed. Post-operative pain, uncorrected visual acuity, and corneal haze data was recorded and analyzed at post-op days 1, 4 and 7 and at post-op months 1, 3, 6 and 12. RESULTS In all groups surgical corrections ranged from -4.00 D to -8.00 D. There was less pain associated with the epi-LASIK procedure especially early (post-op days 1 and 4). Visual recovery was superior within the PRK group during the first post-operative week but by post-op week 4 all three were equal. Haze scores were similar but a trend for less haze was demonstrated with epi-LASIK at 6 and 12 months. CONCLUSION Epi-LASIK has a slight advantage over PRK and LASEK early on in the post-op course with regards to pain. Visual recovery is similar by 4 weeks and is better with PRK early. In addition, epi-LASIK trends toward less significant haze.