Excimer laser epithelial keratomileusis: 2134 examples clinical review

Objective To analyze the safety and efficacy of excimer laser epithelial keratomileusis (LASEK) in the treatment of myopia.Methods It was a retrospective case series study.For the period of 2001-2009 in Beijing Intech Eye Hospital,4628 eyes of 2314 cases with myopia were treated with LASEK.Patients with varying degrees of myopia were grouped for analysis:group Ⅰ,-1.25～-6.00 D,1456 eyes; group Ⅱ,-6.25～-10.00 D,2164 eyes; group Ⅲ,-10.25～-16.75 D,1008 eyes.Postoperative follow-up assessments were performed at 3,6 and 12 months.Postoperative measurements included slit-lamp microscopy for corneal healing,manifest refraction,uncorrected visual acuity (UCVA),refraction (spherical equivalent),intraocular pressure,haze,etc.The results were analyzed with a x2 test and ANOVA by SPSS 13.0 software.Results The postoperative UCVA at 1 year was equal to or greater than 1.0:group Ⅰ (1430 eyes) 98.21％; group Ⅱ (1898 eyes) 87.71％; group Ⅲ (781 eyes) 77.48％.The occurrence of haze at 3-6 months:group Ⅰ (4 eyes) 0.27％; group Ⅱ (50 eyes) 2.31％; these were statistically significant differences in group Ⅲ (90 eyes) 8.93％ (x2=159.4,P＜0.01).The incidences of high intraocular pressure induced by the topical use of corticosteroid eye drops were:group Ⅰ (79 eyes) 5.42％; group Ⅱ (443 eyes) 20.47％; group Ⅲ (266 eyes) 26.39％.The results for the 3 groups showed significant differences (x2=219.4,P＜0.01).Analysis of variance was used to compare the changes in the spherical equivalence of each of the 3 groups at 3 months to 1 year and the differences between any 2 groups.These were statistically significant differences (F=16.813,P＜0.05).Conclusion LASEK is a safe and effective surgical procedure to correct myopia,for a thin cornea,high myopia and ultra high myopia.Intraocular pressure should be monitored during the follow-up periods so the occurrence of steroid-induced glaucoma can be prevented. Key words: Keratomileusis,Excimer laser; Subepithelial; Clinical research