Epipolis–Laser In Situ Keratomileusis Discarding Epithelium Versus Laser In Situ Keratomileusis for Myopia and Myopic Astigmatism in Asian Eyes

PURPOSE: To compare long-term safety, efficacy, predictability, and visual outcomes of epipolis-laser in situ keratomileusis (epi-LASIK) discarding epithelium versus LASIK in Asian eyes. DESIGN: This was a prospective, randomized, bilateral case series. METHODS: This study included 166 eyes of 83 patients with myopia and myopic astigmatism who received epi-LASIK in 1 eye and LASIK in the contralateral eye. Automated separation of the epithelium was performed with epi-K™, and LASIK was performed with M2 microkeratome using 90-μm calibrated heads. Patients were seen post-operatively at 1 and 3 days, 1 week, and on days 1, 3, 7 at 1, 3, 6, and 12 months. Uncorrected visual acuity, best corrected visual acuity, spherical equivalent (SE), contrast sensitivity, total higher-order aberration, corneal sensitivity, and clarity were analyzed. RESULTS: Mean preoperative SE was -4.26 (SD, 1.64) diopters (D) in epi-LASIK and -4.27 (SD, 1.63) D in the LASIK group. Twelve months after surgery, mean SE was 0.04 (SD, 0.40) and 0.11 (SD, 0.30) D, respectively. There was no significant difference in uncorrected visual acuity (P = 0.451), SE (P = 0.157) and contrast sensitivity between groups at the 1-year follow-up (P > 0.05). During 6 months after operation, corneal sensitivity values were significantly lower in the LASIK group (P < 0.05). No eye lost line of best corrected visual acuity in both groups. In epi-LASIK eyes, there was no haze in 97.5% and haze grade 1 in 2.5% at 3 months postoperatively. From 6 months onward, alls corneas were clear. CONCLUSIONS: Epi-LASIK was safe, predictable, and effective and may be considered an alternative for LASIK.