A Control-Matched Comparison of Laser Epithelial Keratomileusis and Laser In Situ Keratomileusis for Low to Moderate Myopia

Purpose: To compare the visual and refractive outcomes of laser epithelial keratomileusis (LASEK) and laser in situ keratomileusis (LASIK) for the treatment of low to moderate myopia. Design: Retrospective, nonrandomized, control-matched study. Methods: The charts of 2257 eyes that underwent LASEK or LASIK treatment were reviewed. Patients who were 21 years of age or older having between -0.75 and -6.00 diopters (D) of myopia with up to -2.25 D of astigmatism were included. One hundred twenty-two LASEK-treated eyes were matched with 122 LASIK-treated eyes having preoperative spheres, cylinders, and spherical equivalent (SE) within ±0.50 D. Both groups had similar preoperative best spectacle-corrected visual acuity (BSCVA), laser platform, and follow-up durations. Outcome measures were visual and refractive results. Results: Preoperatively, the mean SE was -3.50 ± 1.40 D for LASEK and -3.50 ± 1.42 D for LASIK (P = .59). Postoperatively, the mean logarithm of minimum angle of resolution (logMAR) uncorrected visual acuity (UCVA) was 0.01 ± 0.08 (20/21) for LASEK and 0.06 ± 0.12 (20/23) for LASIK; the mean SE was -0.15 ± 0.40 D for LASEK and -0.37 ± 0.45 D for LASIK; and the mean logMAR of BSCVA was -0.03 ± 0.06 (20/19) for LASEK and -0.02 ± 0.05 (20/19) for LASIK. No eye lost 2 or more lines of BSCVA in both groups. Conclusions: Slight differences in the visual and refractive results between LASEK and LASIK were observed, despite the use of the same nomogram. Both procedures were safe, effective, and predictable. Nomogram adjustment may be necessary for LASIK surgeons adopting surface ablation.