Outcomes Similar for LASEK, PRK

Laurie Barclay, MD

January 13, 2004

Jan. 13, 2004 -- There is no significant difference in outcomes between laser subepithelial keratomileusis (LASEK) and photorefractive keratotomy (PRK), according to the results of a randomized trial published in the January issue of the Archives of Ophthalmology.

"LASEK is a newly advocated laser refractive procedure for patients with myopia in whom PRK or laser in situ keratomileusis may not be ideal because of their drawbacks," write Amir Pirouzian, MD, and colleagues from Travis Air Force Base in California. "Recent studies have shown a reduction in pain, faster visual rehabilitation, better visual acuity, and decreased corneal haze in LASEK-treated patients compared with PRK-treated patients.

In this prospective, double-masked study, 30 active-duty military members with mild to moderate myopia had LASEK performed in one eye and PRK in the other eye.

Subjective pain levels on postoperative days 1, 2, and 3 and visual acuity on postoperative days 3, 7, and 30 were statistically similar in both groups. On postoperative day 1, there was a smaller median epithelial defect in the LASEK group than in the PRK group ( P < .001), but by postoperative day 3, the PRK group had smaller epithelial defects than in the LASEK group ( P < .001), and by postoperative day 7, no subjects had detectable epithelial defects.

Half of the patients preferred PRK over LASEK because of shorter surgical time (4 minutes vs. 11 minutes), but the other half preferred LASEK because they did not like the epithelial scrubber used for PRK. After 30 days, patient satisfaction with their final postoperative visual acuity was similar in both cases.

"LASEK and PRK have similar postoperative pain thresholds and visual acuity recordings. However, the epithelial healing pattern for LASEK and PRK differs," the authors write. "Based on our data, we see no additional clinical benefit from the LASEK procedure compared with the PRK procedure in low to moderately myopic eyes."

The authors report no financial conflicts of interest.

Arch Ophthalmol. 2004;122:11-16

Reviewed by Gary D. Vogin, MD

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