Z-LASIK and Trans-PRK for correction of high-grade myopia: safety, efficacy, predictability and clinical outcomes
- 195 Downloads
The aim of the study was to examine the outcomes of transepithelial photorefractive keratectomy (Trans-PRK) and Femtosecond Laser-assisted in situ keratomileusis (Z-LASIK) for the correction of high myopia.
A retrospective cohort study design was used. The study group included 792 eyes with high-grade myopia (− 6.0 diopters or higher) or high-grade myopia with astigmatism that were treated with Z-LASIK or Trans-PRK in 2013 through 2014 in an optical outpatient clinic of a large private medical service. The Trans-PRK group comprised of 674 eyes with a spherical equivalent (SE) of − 7.87 ± 1.46 and the Z-LASIK group comprised of 118 eyes with a SE of − 7.19 ± 0.81 (P < 0.001).
The mean postoperative SE in the Trans-PRK group was − 0.06 and − 0.02 in the Z-LASIK group (P = 0.545). Efficacy index values were 0.92 in the Trans-PRK group and 0.95 in the Z-LASIK group (P = 0.083), and corresponding safety index values were 0.95 and 0.97 (P = 0.056). An UCVA of 20/40 or better was achieved in 94.20% of eyes in the Trans-PRK group, and 98.31% in the Z-LASIK group (P = 0.063). The majority of eyes in both the Trans-PRK and Z-LASIK groups were within ± 0.5D of attempted correction: 59.35 and 64.71%, respectively (P = 0.271).
Both Trans-PRK and Z-LASIK demonstrated excellent efficacy, safety and predictability profiles, with results comparable and in some cases superior to the current literature. Results of Z-LASIK were slightly better than those of Trans-PRK, though the preoperative SE of the latter was higher.
KeywordsHigh myopia FS-LASIK Trans-PRK Refractive surgery Efficacy Safety Predictability
- 7.Wang DM, Du Y, Chen GS, Tang LS, He JF (2012) Transepithelial photorefractive keratectomy mode using SCHWIND-ESIRIS excimer laser: initial clinical results. Int J Ophthalmol 5(3):334–337. https://doi.org/10.3980/j.issn.2222-3959.2012.03.16 Google Scholar
- 14.Wu W, Wang Y (2015) The correlation analysis between corneal biomechanical properties and the surgically induced corneal high-order aberrations after small incision lenticule extraction and femtosecond laser in situ keratomileusis. J Ophthalmol 2015:758196. https://doi.org/10.1155/2015/758196 Google Scholar
- 20.Vestergaard A, Ivarsen A, Asp S, Hjortdal JO (2013) Femtosecond (FS) laser vision correction procedure for moderate to high myopia: a prospective study of ReLEx((R)) flex and comparison with a retrospective study of FS-laser in situ keratomileusis. Acta Ophthalmol 91(4):355–362. https://doi.org/10.1111/j.1755-3768.2012.02406.x CrossRefGoogle Scholar
- 22.Tomita M, Watabe M, Yukawa S, Nakamura N, Nakamura T, Magnago T (2014) Safety, efficacy, and predictability of laser in situ keratomileusis to correct myopia or myopic astigmatism with a 750 Hz scanning-spot laser system. J Cataract Refract Surg 40(2):251–258. https://doi.org/10.1016/j.jcrs.2013.07.043 CrossRefGoogle Scholar
- 23.Kulkamthorn T, Silao JN, Torres LF, Lim JN, Purcell TL, Tantayakom T, Schanzlin DJ (2008) Wavefront-guided laser in situ keratomileusis in the treatment of high myopia by using the CustomVue wavefront platform. Cornea 27(7):787–790. https://doi.org/10.1097/ICO.0b013e31816a3554 CrossRefGoogle Scholar
- 25.Stonecipher KG, Kezirian GM, Stonecipher M (2010) LASIK for − 6.00 to − 12.00 D of myopia with up to 3.00 D of cylinder using the ALLEGRETTO WAVE: 3- and 6-month results with the 200- and 400-Hz platforms. J Refract Surg 26(10):S814–S818. https://doi.org/10.3928/1081597X-20100921-08 CrossRefGoogle Scholar
- 27.Hashmani N, Hashmani S, Ramesh P, Rajani H, Ahmed J, Kumar J, Kumar A, Jamali M (2017) A comparison of visual outcomes and patient satisfaction between photorefractive keratectomy and femtosecond laser-assisted in situ keratomileusis. Cureus 9(9):e1641. https://doi.org/10.7759/cureus.1641 Google Scholar
- 30.Gazieva L, Beer MH, Nielsen K, Hjortdal J (2011) A retrospective comparison of efficacy and safety of 680 consecutive lasik treatments for high myopia performed with two generations of flying-spot excimer lasers. Acta Ophthalmol 89(8):729–733. https://doi.org/10.1111/j.1755-3768.2009.01830.x CrossRefGoogle Scholar
- 32.Chamon W, Alleman N (2008) Refractive surgery outcomes and frequency of complications in management of complications in refractive surgery. Springer, BerlinGoogle Scholar