LASEK appears safe, effective for mild to moderate myopia

April 1, 2008

A long-term study of 292 eyes found that LASEK is a safe and effective treatment for patients with low to moderate levels of myopia. A significant difference was seen in spherical equivalent and uncorrected vision acuity preoperatively to postoperatively.

Key Points

Istanbul, Turkey-The long-term results of LASEK in patients with mild to moderate myopia indicate that the procedure seems to be a safe and effective treatment for this patient population, according to Yasar Kucuksumer, MD, deputy chief, eye clinic, Beyoglu Eye Educational and Research Hospital, Istanbul, Turkey.

"LASEK was first described in 1999 to eliminate the disadvantages of both LASIK and PRK. While PRK is a good procedure, haze is especially a problem postoperatively, and dry eye, corneal ectasia, and flap complications are problems after LASIK," he said. "We carried out the current study to determine the long-term results of LASEK in patients with mild to moderate myopia regarding efficiency, safety, and refractive stability."

The study was conducted from 2001 to 2003 and included 292 eyes of 152 patients (78 men and 74 women) with a mean age of 27.4 years. The refractive error did not exceed-6.0 D. Patients had a mean follow-up of about 4.5 years.

Dr. Kucuksumer said he uses the following technique:

Dr. Kucuksumer said he prescribes ketorolac (Acular LS, Allergan) eye drops along with artificial tears four times daily.

Results

The spherical equivalent (SE) was –2.6 D preoperatively, –0.35 D at 1 month, –0.26 D at 3 months, and –0.40 D at the final visit.

"There was a significant difference in the SE and the uncorrected visual acuity [UCVA] from preoperatively to postoperatively," Dr. Kucuksumer said. "There was no significant difference in the best-corrected visual acuity [BCVA] at the last visit compared with preoperatively."

Also, he added, no difference existed in the preoperatively UCVA and BCVA during the follow-up period, and no difference was noted in the preoperative SE and BCVA at the final visit.

The final postoperative UCVA was 20/25 in 270 eyes (92.5%), Dr. Kucuksumer said. The early postoperative corneal haze that developed in 85% of cases in the early postoperative period resolved in most cases after therapy with topical steroids. Bacterial keratitis developed in one eye, and the patient lost three lines of BCVA. Eight eyes had corneal haze that resulted in the loss of one line of BCVA.