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Published on: September 16, 2025
Comparison between femtosecond laser-assisted sub-Bowman keratomileusis vs laser subepithelial keratectomy to correct
Laura de Benito-Llopis1, Miguel A Teus, Raquel Gil-Cazorla
1Vissum Madrid, C/ Santa Hortensia, Madrid, Spain. lbenito@vissum.com
Purpose:
To compare femtosecond laser sub-Bowman keratomileusis (FSBK) vs laser subepithelial keratectomy (LASEK) to correct myopia.
Design:
Retrospective, nonrandomized, interventional, comparative case series.
Methods:
Two thousand one hundred and eight eyes were included in the study. We compared 1,072 eyes treated with FSBK vs 1,036 eyes treated with LASEK with or without mitomycin C (MMC). Visual and refractive results were evaluated 1 day, 1 week, and 1 and 3 months postoperatively.
Results:
Preoperative mean sphere and best spectacle-corrected visual acuity (BSCVA) were -3.93 diopters (D) vs -3.87 D (P = .5) and 1.12 vs 1.12 (P = .8) in FSBK and LASEK, respectively. Uncorrected visual acuity (UCVA) was 0.92 vs 0.62, 0.98 vs 0.78, 0.96 vs 0.91, and 1.06 vs 1.03 in FSBK and LASEK, respectively, at 1 day, 1 week, and 1 and 3 months after surgery (P < .01 for all comparisons). Three months postoperatively, BSCVA was 1.13 and 1.10, respectively (P = .001). At that moment, 20 eyes (1.93%) in the LASEK group vs 9 eyes (0.84%) in the FSBK group had lost 2 or more lines of BSCVA. Ten eyes (0.96%) in the LASEK group gained 2 or more lines of BSCVA, whereas 3 eyes (0.28%) in the FSBK group gained 2 lines. Six months postoperatively, only 2 LASEK eyes (0.19%) showed loss of 2 or more lines of BSCVA, compared to 3 FSBK-treated eyes (0.28%).
Conclusion:
Both FSBK and LASEK are safe and effective procedures to correct myopia. Slightly better visual and refractive results were observed in FSBK-treated eyes in a 3-month follow-up.
