Sub-Bowman keratomileusis compared with photorefractive keratectomy--contralateral eye study

The aim of this study was to compare two different refractive surgery approaches in correction of myopia with or without astigmatism. In patients where one eye underwent sub-Bowman keratomileusis (SBK) and the other eye photorefractive keratectomy (PRK), the objective and subjective results were retrospectively compared during the six-month follow-up. Eighty four patients (168 eyes) were involved in this retrospective contralateral study. The mean preoperative spherical refraction was -3.88 diopters (D) and the mean cylinder was -0.82 D for all eyes. Each patient underwent SBK on one eye and PRK on the contralateral eye. The eyes in the PRK group underwent mechanical epithelial removal, which was followed by laser treatment. Mitomycin C 0.02% was used for 15 seconds if ablation was deeper than 50 microns. In the SBK group, the intended 100-microm corneal flap was created with IntraLase femtosecond laser. All eyes underwent customized wavefront guided laser ablation using a VISX Star S4 IR excimer laser. Preoperative and postoperative outcome measures included best spectacle-corrected visual acuity, uncorrected visual acuity, corneal topography, contrast visual acuity, and anterior optical coherence tomography imaging. Patients were asked to complete subjective satisfaction questionnaires at each visit. Through the first 3 months of follow up, the SBK eyes demonstrated clinically and statistically better visual results than PRK eyes, between 3 and 6 months the results in the two groups began to equalize, and after 6 months of follow up there were no clinical and statistical differences between the SBK and PRK groups. SBK seems to be more practical for the patient with less pain, faster visual recovery, fewer medications, and overall superior experience.