Laser in Situ Keratomileusis versus Laser Assisted Subepithelial Keratectomy for the Correction of Low to Moderate Myopia and Astigmatism

Purpose: To compare the visual and refractive outcomes of laser in situ keratomileusis (LASIK) versus laser assisted subepithelial keratectomy (LASEK) in the treatment of low to moderate myopia and astigmatism Methods: A retrospective comparative case series study comprised 2,474 eyes of patients with manifest refraction spherical component lower than -5.00 diopters (D) and cylinder components lower than -3.00 D were assigned to 2 groups: 1,238 eyes were treated with LASIK and 1,236 eyes with LASEK. Uncorrected visual acuity (UCVA), best spectacle corrected visual acuity (BSCVA), remaining refractive error, and complications were evaluated at 1 week, 2, 6, 12, and 36 months postoperation. Results: Preoperatively the mean refractive spherical equivalent (MRSE) was -3.42 D±1.01 (SD) in LASIK group and -3.36 D±1.01 (SD) in LASEK group, at 2 months it was -0.12 D±0.279 and -0.37 D±0.341, at 36 months postoperation in LASIK group it was -0.06 D±0.25 and in LASEK group it was -0.14±0.28 D, respectively. At 2 and 36 months, UCVA was 20/20 in 91.5% and 77.8% in LASIK group and, 94.7% and 90.9% in LASEK group, respectively. At 2 and 36 months, 95.4% and 78.7% in LASIK, 97.3% and 94.2% in LASEK group respectively were within ±0.5 D of emmetropia. Diffuse lamellar keratitis (DLK) in 5.9% and corneal ectasia in 1.05% of eyes (N=13) in the LASIK group and corneal haze in 10.6% (N=131) eyes in the LASEK group were seen. Conclusion: Both LASIK and LASEK were safe and effectively treated eyes with low to moderate myopia and astigmatism. LASEK provided superior results in visual outcomes