A prospective bilateral comparison of epi-LASIK and LASEK for myopia.

PURPOSE: To compare the clinical and confocal microscopic results of mechanical (epi-LASIK) versus alcohol-assisted laser epithelial keratomileusis (LASEK) for the correction of myopia.

METHODS: Twenty-five patients with myopia received epi-LASIK in one eye and LASEK in the other. The difference of spherical equivalent refraction of myopia and astigmatism was less than 1.00 diopter (D) in two eyes of each case. Mechanical separation of the epithelium was performed with the Lasitome epithelial separator and alcohol-assisted separation with 25 second application of 18% alcohol. Ablation was performed with the ESIRIS laser. Patients were seen daily until epithelial closure, and at 1, 3, 6, and 12 months. Time to epithelial healing, uncorrected visual acuity (UCVA), manifest refraction, haze, and grey scale value in confocal microscopy were recorded.

RESULTS: Preoperative myopic spherical equivalent refraction was -3.95+/-1.49 D in the epi-LASIK and -3.91+/-1.39 D in the LASEK-treated eyes. The mean time to epithelial healing was slightly longer after epi-LASIK (4.86+/-0.64 vs 4.18+/-0.58 days). Of both epi-LASIK and LASEK-treated eyes, 92% achieved 20/20 or better UCVA and were within +/-0.50 D of emmetropia at 12 months. The grade of haze and mean grey scale value in confocal microscopy were similar in epi-LASIK and LASEK-treated eyes at all postoperative periods. One eye treated with epi-LASIK suffered a minor stromal cut.

CONCLUSIONS: Epi-LASIK and LASEK offer effective correction of myopia with comparable results at 1 year.