Laser epithelial keratomileusis for the treatment of low to moderate myopia: preliminary results

To analyze the refractive outcome and the postoperative pain and corneal haze following laser epithelial keratomileusis (LASEK) for the treatment of low to moderate myopia. A monocentric prospective noncomparative study was started in June 2000, after informed consent was obtained from patients with a spherical equivalent of less than -5 diopters (D). This study actually was part of another prospective comparative study where the contralateral eye underwent photorefractive keratectomy. An epithelial debridement was performed using diluted ethanol, the epithelial flap was lifted, photoablation was performed, the flap was put back in place, and secured by a bandage contact lens. The refractive outcome was assessed, and postoperative pain and haze were graded using an analogical visual scale from 0 to 10 and a scale of 0 to 4, respectively. We included 17 eyes of 16 patients. LASEK was performed successfully in 15 eyes (88.2%). One of these eyes could not be assessed for the refractive outcome and postoperative haze because the epithelial flap was torn during contact lens removal. The mean postoperative pain level during the night following the procedure was 5.7+/-2.0. The mean preoperative spherical equivalent (SE) was -2.5+/-1.0 D, and after a 2-month follow-up, the mean postoperative SE was +0.26+/-0.6 D. Twelve eyes (85.7%) and 10 eyes (71.4%) were within +/-1.0 D and +/-0.5 D from the attempted correction, respectively. The corneal haze grade was less than 1 in 12 eyes (85.7%) and equal to 1 in two eyes (14.3%). No complications and no loss of postoperative best-corrected visual acuity were noted. LASEK appears to be a reliable and reproducible technique for the treatment of myopia-associated SE of less than -5 D. Postoperative pain is moderate and flap-related complications of LASIK are avoided.