International Ophthalmology

, Volume 39, Issue 4, pp 753–763 | Cite as

Z-LASIK and Trans-PRK for correction of high-grade myopia: safety, efficacy, predictability and clinical outcomes

  • Assaf Gershoni
  • Michael Mimouni
  • Eitan Livny
  • Irit BaharEmail author
Original Paper



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.


High myopia FS-LASIK Trans-PRK Refractive surgery Efficacy Safety Predictability 


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Copyright information

© Springer Science+Business Media B.V., part of Springer Nature 2018

Authors and Affiliations

  • Assaf Gershoni
    • 1
    • 2
    • 3
  • Michael Mimouni
    • 4
  • Eitan Livny
    • 1
    • 2
    • 3
  • Irit Bahar
    • 1
    • 2
    • 3
    Email author
  1. 1.Assuta Optic, Assuta Medical CenterTel AvivIsrael
  2. 2.Division of OphthalmologyBeilinson Hospital, Rabin Medical CenterPetach TikvaIsrael
  3. 3.Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael
  4. 4.Department of OphthalmologyRambam Health Care CampusHaifaIsrael

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