Photorefractive keratectomy versus laser in situ keratomileusis: a control-matched study

Ophthalmology. 2000 Feb;107(2):251-7. doi: 10.1016/s0161-6420(99)00043-3.

Abstract

Objective: Photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK) outcomes were compared at 1, 3, 6, and 12 months after surgery.

Design: Retrospective, nonrandomized, comparative study.

Participants: One hundred seven LASIK-treated eyes (58 patients) and 107 PRK-treated eyes (91 patients) having myopia between -1 and -9.50 diopters (D). All LASIK-treated eyes were analyzed retrospectively and matched with PRK-treated eyes having sphere within +/-0.25 D, +/-1 D of cylinder, and +/-7 years of age.

Intervention: For PRK and LASIK, the refractive surgery was performed with the slit-scanning excimer laser Nidek EC-5000, (Nidek Co. Tokyo, Japan)

Main outcome measures: Manifest refraction, best-spectacle and uncorrected Snellen visual acuity, haze, halos, and keratometry were evaluated before surgery and up to 12 months after surgery.

Results: Seventy percent of eyes were evaluated at the 12-month postoperative exam. Of these eyes, 83% of LASIK cases and 86% of PRK cases had uncorrected visual acuities of 20/20 or better. Refractions within +/-0.5 D represented 78% of the LASIK eyes and 83% of the PRK eyes at that follow-up. Patients who underwent LASIK reported halos twice as often as patients who underwent PRK using a subjective scale. The odds ratio of high halos for LASIK versus PRK was 3.50 (95% confidence interval, 1.89-6.46; P<0.0001). At 1 month after surgery, 64% of the LASIK eyes were within +/-0.50 D compared with 77% of the PRK eyes. No eye lost 2 Snellen lines of best corrected visual acuity at 6 or 12 months after surgery. Ten PRK eyes (9.3%) and three LASIK eyes (2.8%) were retreated.

Conclusions: PRK and LASIK achieved equal refractive outcomes at all postoperative follow-ups, but LASIK patients were twice as likely to experience halos.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Astigmatism / physiopathology
  • Case-Control Studies
  • Cornea / surgery*
  • Glare
  • Humans
  • Keratomileusis, Laser In Situ / adverse effects
  • Keratomileusis, Laser In Situ / methods*
  • Lasers, Excimer
  • Myopia / surgery*
  • Photorefractive Keratectomy / adverse effects
  • Photorefractive Keratectomy / methods*
  • Pupil / physiology
  • Refraction, Ocular
  • Retrospective Studies
  • Treatment Outcome
  • Vision Disorders / etiology
  • Visual Acuity / physiology