[Comparison of laser in situ keratomileusis and laser-assisted subepithelial keratectomy for myopia more than -10.00 diopters].

OBJECTIVE: To compare the visual and refractive outcomes of laser in situ keratomileusis (LASIK) and laser-assisted subepithelial keratectomy (LASEK) in the treatment of severe myopia. METHODS: LASEK and LASIK were respectively performed on 165 eyes of 100 patients with super high myopia by using the Allegretto Wavelight-Wave 1,007 excimer laser, of which 10(6) eyes (62 patients) were treated with LASEK and 59 eyes (38 patients) with LASIK. Uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), remaining refractive error, corneal haze and complications were followed up in both groups for 12 months. RESULTS: At the end of 6 months and 12 months no significant statistic difference between LASEK and LASIK group in the clinical outcomes of refractive corrections (mean spherical equivalent, MSE). At the end of 1 week and 1 month postoperatively, UCVA in the LASIK eyes was better than in LASEK eyes. At the end of 3, 6, 12 months, it was almost the same in these two groups. The percentage of eyes with UCVA better than 1.0 (47.8% in LASEK, 52.5% in LASIK) was higher in LASEK group. There was no significant difference between the two groups in the percentage of eyes losing one or more lines of BSCVA in Snellen visual acuity chart. At the end of 12 months, the mean SE was within +/-0.5D of emmetropia in 9 eyes (13.2%) in the LASEK group and 11 eyes (18.6%) in the LASIK group and within +/-1.0D of emmetropia in 36 eyes (52.9%) in the LASEK group and 28 eyes (47.5%) in the LASIK group, respectively, the between-group differences were not statistically significant (P>0.05). There were more complaints of postoperative pain and discomfort after LASEK procedure. No severe vision threatening complications in these two groups were found. CONCLUSION: Both LASIK and LASEK are safe and effective in treating eyes with severe myopia.