Comparison of visual and refractive outcomes between femtosecond laser-assisted in situ keratomileusis (FS-LASIK) and photorefractive keratectomy (PRK): a long-term outcomes analysis

Aim: We aimed to compare the results of photorefractive keratectomy (PRK) and femtosecond-assisted laser in situ keratomileusis (FS-LASIK) procedures in the treatment of myopia and myopic astigmatism. Material and Method: Seventy eyes of 35 patients with myopia and/or myopic astigmatism who had undergone PRK procedure were compared retrospectively with 70 eyes of 35 patients with myopia and/or myopic astigmatism who had undergone FS-LASIK procedure. Results: All patients completed the 2-year follow-up period. With respect to age and sex, PRK and FS-LASIK groups were comparable. The differences in uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and spherical equivalent were significantly better with PRK than with FS-LASIK at 6- and 24-month visits. FS-LASIK and PRK had similar values of safety index, efficacy index, and predictability at 6 and 24 months postoperatively. No significant complications were observed in neither of the procedures during the follow-up period. Conclusion: Both PRK and FS-LASIK seem equally effective options for the correction of myopia and myopic astigmatism. However, PRK provided slightly better visual and refractive outcomes than FS-LASIK at 6 and 24 months postoperatively.

Keywords:

Laser in situ keratomileusis, Myopia, Myopic astigmatism, Photorefractive keratectomy Refractive surgery,

PDF

___

Srinivasan R. Ablation of polymers and biological tissue by ultraviolet lasers. Science (New York, NY). 1986; 234: 559-65.
Chen S, Feng Y, Stojanovic A, Jankov MR, 2nd, Wang Q. IntraLase femtosecond laser vs mechanical microkeratomes in LASIK for myopia: a systematic review and meta-analysis. J Refract Surg (Thorofare, NJ : 1995) 2012; 28: 15-24.
Kymionis GD, Kankariya VP, Plaka AD, Reinstein DZ. Femtosecond laser technology in corneal refractive surgery: a review. J Refract Surg (Thorofare, NJ: 1995) 2012; 28: 912-20.
Shortt AJ, Bunce C, Allan BD. Evidence for superior efficacy and safety of LASIK over photorefractive keratectomy for correction of myopia. Ophthalmology 2006; 113: 1897-908.
Majmudar PA, Forstot SL, Dennis RF, et al. Topical mitomycin-C for subepithelial fibrosis after refractive corneal surgery. Ophthalmology 2000; 107: 89-94.
Miraftab M, Hashemi H, Asgari S. Matched optical quality comparison of 3-year results of PRK-MMC and phakic IOL implantation in the correction of high myopia. Eye (London, England) 2015; 29: 926-31.
Hashemi H, Miraftab M, Asgari S. Comparison of the visual outcomes between PRK-MMC and phakic IOL implantation in high myopic patients. Eye (London, England) 2014; 28: 1113-8.
Rajan MS, Jaycock P, O'Brart D, Nystrom HH, Marshall J. A long-term study of photorefractive keratectomy; 12-year follow-up. Ophthalmology 2004; 111: 1813-24.
Castro-Luna G, Jimenez-Rodriguez D, Perez-Rueda A, Alaskar-Alani H. Long Term Follow-Up Safety and Effectiveness of Myopia Refractive Surgery. Int J Environ Res Public Health 2020; 17.
Taneri S, Knepper J, Rost A, Dick HB. [Long-term outcomes of PRK, LASIK and SMILE]. Ophthalmologe 2021.
Steinert RF, Hersh PS. Spherical and aspherical photorefractive keratectomy and laser in-situ keratomileusis for moderate to high myopia: two prospective, randomized clinical trials. Summit technology PRK-LASIK study group. Trans Am Ophthalmol Soc 1998; 96: 197-221.
Hersh PS, Brint SF, Maloney RK, et al. Photorefractive keratectomy versus laser in situ keratomileusis for moderate to high myopia. A randomized prospective study. Ophthalmology. 1998; 105: 1512-22.
Alió JL, Ortiz D, Muftuoglu O, Garcia MJ. Ten years after photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK) for moderate to high myopia (control-matched study). Br J Ophthalmol 2009; 93: 1313-8.
Pallikaris IG, Siganos DS. Excimer laser in situ keratomileusis and photorefractive keratectomy for correction of high myopia. J Refract Corneal Surg 1994; 10: 498-510.
Wallau AD, Campos M. Photorefractive keratectomy with mitomycin C versus LASIK in custom surgeries for myopia: a bilateral prospective randomized clinical trial. J Refract Surg (Thorofare, NJ : 1995) 2008; 24: 326-36.
Ghadhfan F, Al-Rajhi A, Wagoner MD. Laser in situ keratomileusis versus surface ablation: visual outcomes and complications. J Cataract Refract Surg 2007; 33: 2041-8.
Aslanides IM, Georgoudis PN, Selimis VD, Mukherjee AN. Single-step transepithelial ASLA (SCHWIND) with mitomycin-C for the correction of high myopia: long term follow-up. Clin Ophthalmol (Auckland, NZ) 2015; 9: 33-41.
Van Gelder RN, Steger-May K, Yang SH, Rattanatam T, Pepose JS. Comparison of photorefractive keratectomy, astigmatic PRK, laser in situ keratomileusis, and astigmatic LASIK in the treatment of myopia. J Cataract Refract Surg 2002; 28: 462-76.
Chhadva P, Cabot F, Galor A, Karp CL, Yoo SH. Long-term outcomes of flap amputation After LASIK. J Refract Surg (Thorofare, NJ: 1995) 2016; 32: 136-7.
Zhao W, Zhang Y. Comparison and predictive factors analysis for efficacy and safety of Kirschner wire, anatomical plate fixation and cannulated screw in treating patients with open calcaneal fractures. Medicine 2019; 98: e17498.