Contralateral-eye study of surface refractive treatments: clinical and confocal microscopy evaluation

J Cataract Refract Surg. 2014 Feb;40(2):224-31. doi: 10.1016/j.jcrs.2013.07.049. Epub 2013 Dec 25.

Abstract

Purpose: To compare the visual and refractive outcomes and the corneal structural changes in myopic patients after surface refractive treatments (ie, photorefractive keratectomy [PRK] with adjuvant mitomycin-C [MMC] and epithelial laser in situ keratomileusis [epi-LASIK]).

Setting: University of Crete, Heraklion, Crete, Greece.

Design: Prospective comparative case series.

Methods: One eye of consecutive myopic patients was randomly assigned to PRK-MMC, and the fellow eye was treated with epi-LASIK. Visual and refractive outcomes and corneal confocal microscopy findings were evaluated. All patients were examined preoperatively and 1, 3, 6, 12, and 24 months postoperatively.

Results: Twenty-six eyes (13 patients) were included. The mean follow-up was 2.47 years ± 0.35 (SD) (range 1.64 to 2.93 years). In the PRK-MMC group, the mean preoperative spherical equivalent refraction was -3.84 ± 1.59 diopters (D) (range -1.5 to -8.7 D) and -0.21 ± 0.44 D (range -0.5 to 1.0 D) at the last follow-up and in the epi-LASIK group, -3.91 ± 1.48 D (range -1.5 to -8.5 D) and -0.18 ± 0.36 (range +0.5 to -0.5 D), respectively. Qualitative analysis of the subepithelial nerve plexus, haze development, and keratocyte distribution were similar in the 2 groups. There was no statistically significant difference in endothelial cell density between the groups throughout the follow-up (P>.05).

Conclusion: Epithelial LASIK and PRK-MMC gave similar visual, refractive, and corneal structural outcomes in patients with myopia for up to 2 years postoperatively.

Financial disclosure: No author has a financial or proprietary interest in any material or method mentioned.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Alkylating Agents / administration & dosage*
  • Cell Count
  • Combined Modality Therapy
  • Cornea / innervation
  • Cornea / pathology*
  • Corneal Keratocytes / pathology
  • Endothelium, Corneal / pathology
  • Female
  • Follow-Up Studies
  • Humans
  • Keratomileusis, Laser In Situ*
  • Lasers, Excimer / therapeutic use*
  • Male
  • Microscopy, Confocal
  • Mitomycin / administration & dosage*
  • Myopia / pathology
  • Myopia / surgery*
  • Ophthalmic Nerve / pathology
  • Photorefractive Keratectomy*
  • Prospective Studies
  • Refraction, Ocular / physiology
  • Treatment Outcome
  • Visual Acuity / physiology
  • Young Adult

Substances

  • Alkylating Agents
  • Mitomycin