[Clinical outcomes after laser epithelial keratomileusis (LASEK) and transepithelial photorefractive keratectomy (TPRK) in myopia]

Objective: To compare the clinical outcomes between laser epithelial keratomileusis (LASEK) and transepithelial photorefractive keratectomy (TPRK) for treatment of myopia. Methods: Case-control study. We reviewed a total of 90 right eyes that underwent either LASEK or TPRK, with 45 eyes in each group (aged between 18 and 40 years; 9 males and 16 females in the LASEK group, and 30 males and 15 females in the TPRK group) from 2015 to 2016 in Peking Union Medical College Hospital and Tangshan Eye Hospital. All the patients were followed up for 6 months postoperatively. Pain, uncorrected visual acuity (UCVA), and haze were measured at postoperative 3 days, 7 days, 1 month, 3 months and 6 months, and compared using an independent Student t-test between the two groups. Degree of haze, eye pain score, and visual acuity were compared by the Mann-Whitney U test. Results: At 3 days, the pain score was 1 (0,3) in the LASEK group versus 0 (0,1) in the TPRK group (Z=5.643, P=0.001). The UCVA was 4.80±0.10 in the LASEK group versus 4.97±0.07 in the TPRK group (Z=6.930, P=0.000) at 3 days, 4.98±0.08 in the LASEK group versus 5.05±0.06 in the TPRK group (Z=8.147, P=0.000) at 7 days, and 5.02±0.05 in the LASEK group versus 5.06±0.06 in the TPRK group (Z=2.381, P=0.017) at 1 month. The UCVA was also measured at 3 months, 5.07±0.07 versus 5.10±0.07 (Z=1.632, P=0.103), and at 6 months, 5.10±0.07 versus 5.11±0.07 (Z=0.798, P=0.425), respectively, with no statistical significance. The residual diopter was (0.17±0.19) D in the LASEK group versus (0.17±0.20) D in the TPRK group (Z=0.097, P=0.923) at 1 month, (0.03±0.11) D versus (0.07±0.14) D (Z=0.166, P=0.096) at 3 months, (0.07±0.13) D versus (0.07±0.14) D (Z=0.002, P=0.978) at 6 months, respectively. The surface regularity index (SRI) was 0.48±0.09 in the LASEK group and 0.46±0.06 in the TPRK group (t=0.88, P=0.37) at 1 month, and 0.49±0.07 in the LASEK group versus 0.47±0.06 in the TPRK group (t=1.53, P=0.132) at 3 months. Transient haze was documented in 1 eye in each group at 1 month (4.4%), with a maximum index of 0.5. No haze was observed in either group at 6 months. Conclusion: TPRK has the advantages of faster early vision recovery and significantly less pain over LASEK. (Chin J Ophthalmol, 2019, 55: 122-126).

[Advantages and disadvantages of femtosecond laser assisted LASIK and SMILE]

With the development of excimer laser and femtosecond laser equipment, application of diversified and customized surgical decision in modern corneal refractive surgery has been an inevitable trend. However, how to make a personalized decision with an accurate surgical design to achieve better visual quality becomes the main focus in clinical applications. Small-incision lenticule extraction (SMILE) and femtosecond assisted laser in situ keratomileusis (FS-LASIK) have been commonly acknowledged as the mainstream of corneal refractive surgery for ametropia correction nowadays. Both methods have been verified by clinical practice for many years. This article compares and elaborates the different characteristics with advantages and disadvantages of the two methods so as to provide some reasonable treatment options for refractive surgery. (Chin J Ophthalmol, 2018, 54: 7-10).