Laser-assisted subepithelial keratectomy versus epipolis laser in situ keratomileusis for myopia: a meta-analysis of clinical outcomes

Background To identify possible differences between laser‐assisted subepithelial keratectomy and epipolis laser in situ keratomileusis for myopia. Design Meta‐analysis. Participants Patients from previously reported comparative studies treated by laser‐assisted subepithelial keratectomy versus epipolis laser in situ keratomileusis. Methods A systematic literature retrieval was conducted in the MEDLINE, EMBASE and Cochrane Library, up to January 2013. The included studies were subject to a meta‐analysis using a RevMan 5.1 version software. Main Outcome Measures The differences in efficacy, predictability, safety, epithelial healing time, pain perception and corneal haze formation. Results A total of six studies involving 517 eyes were included. There were no statistically significant differences in the final proportion of eyes with uncorrected visual acuity of 6/6 or better (P = 0.43), mean postoperative uncorrected visual acuity (P = 0.53), final proportion of eyes with refraction within ± 0.50 D (P = 0.62) and ± 1.00 D (P = 0.16) of target, final proportion of eyes losing two or more lines of best spectacle‐corrected visual acuity (P = 1.00), healing time of corneal epithelium (P = 0.58), final proportion of eyes with corneal haze grade 0.5 or higher (P = 0.26), and corneal haze levels (P = 0.36). Conclusions There were no significant differences in efficacy, predictability, safety, epithelial healing time and corneal haze formation between laser‐assisted subepithelial keratectomy and epipolis laser in situ keratomileusis, but the result was limited. Future more data are required to detect the potential differences between the two procedures.