Flap removal or flap preservation during LASEK surgery

The objective of this study was to evaluate the effectiveness of corneal epithelial flap removal or flap preservation during LASEK operation on myopia and to determine whether there was any accrual of benefit in either approach. From March 2006 to March 2008, some 582 patients (1,164 eyes) who presented with myopia and myopic astigmatism were treated with corrective LASEK operations. They were divided into two groups: one group underwent corneal flap-preservation while the other had the corneal flap removed. Each group comprised 582 eyes, and the data accumulated were retrospectively analyzed. Each patient was examined after 1, 3, 5, and 7 days; 2 weeks; and 1, 2, 3, 6, and 12 months after LASEK surgery to determine their post-operative visual acuity and check for complications. All eyes achieved pre-operative corrected vision 16 weeks after LASEK surgery, with no difference being observed between the two groups. However, there was a significant difference in the ophthalmalgia observed 3 days after LASEK surgery, with the flap-removal group experiencing less post-operative pain than those who had the corneal flap preserved. Furthermore, by 3 days post-operation, the observed corneal epithelial healing was significantly different: again the eyes of those who had the corneal flap removed having a faster recovery than those belonging to the corneal preservation group. In conclusion, the patients who had a flap-removal LASEK operation recorded faster recovery and suffered less ophthalmalgia, but there was no significant difference in the overall outcome in terms of post-operative optimally corrected vision or complications such as haze formation.