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Clinical outcomes of epi-LASIK: 1-year results of on- and off-flap procedures with and without mitomycin-C
  1. Seong Taeck Kim1,
  2. Jae Woong Koh1,
  3. Gil Joong Yoon2,
  4. Seong Won Yang1
  1. 1Department of Ophthalmology, Chosun University College of Medicine, Gwangju, Republic of Korea
  2. 2Happy Eye Clinic, Gwangju, Republic of Korea
  1. Correspondence to Dr Jae Woong Koh, Department of Ophthalmology, Chosun University College of Medicine, #588 Seoseok-dong, Dong-gu, Gwangju, 501-140, Republic of Korea; clearcornea{at}


Aim To evaluate and compare the clinical outcomes of epi-laser in situ keratomileusis (LASIK) performed either on-flap or off-flap with or without 0.02% mitomycin-C (MMC) in terms of corneal haziness, pain scores and satisfaction scores.

Methods In this non-randomised comparative retrospective study, the charts of 198 patients (394 eyes) who had undergone an epi-LASIK procedure for myopia (−1.5 D to −8.0 D spherical equivalent) correction were reviewed. Patients were classified into four groups: Group I, on-flap without MMC, 181 eyes; Group II, on-flap with MMC, 52 eyes; Group III, off-flap without MMC, 93 eyes; Group IV, off-flap with MMC, 68 eyes. We compared the group outcomes on the first day, 1, 3 and 6 months and 1 year after the operation.

Results The mean uncorrected visual acuity was significantly better in the off-flap groups (III and IV) than in the on-flap groups (I and II) on day 1 (p=0.002). There was no significant difference in the spherical equivalent among all groups at 1 year (p=0.305). Some degree of haziness was present in 10 eyes (Grade II: 2; Grade I: 8), but the haziness level was not significantly different among groups at 1 year (p=0.533). Pain scores (0−10) were lower in the off-flap groups (III and IV) (p=0.010). Satisfaction scores (0–10) were higher in the off-flap groups (III and IV), but the difference was not statistically significant (p=0.248).

Conclusions Myopic correction by epi-LASIK surgery with all four methods showed stable visual results in terms of the 1-year postoperative clinical outcomes. Haziness levels revealed that treatment with 0.02% MMC was less effective than expected. Overall, the off-flap method offered faster visual recovery and less postoperative pain than the on-flap method.

  • Epi-LASIK
  • flap
  • mitomycin-C
  • refractive surgery
  • myopia
  • cornea
  • optics and refraction
  • treatment surgery
  • treatment lasers
  • clinical trial

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  • Competing interests None.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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