Ablation depth and its effects on corneal biomechanical changes in laser in situ keratomileusis and epipolis laser in situ keratomileusis

To assess the corneal biomechanical parameters prior to and following laser in situ keratomileusis (LASIK) and epipolis laser in situ keratomileusis (epi-LASIK) and evaluate the probable correlative factors. Corneal hysteresis (CH), corneal resistance factor (CRF) and other biomechanical metrics were measured and evaluated with an ocular response analyzer preoperatively and 1 month postoperatively. Compared with preoperative values, CH and CRF decreased significantly after surgery in both groups (P = 0.000). The LASIK group exhibited a positive correlation between ablation depth (AD) and ∆CH/∆CRF with a strong r value (r = 0.543, P = 0.000; r = 0.574, P = 0.000). In the epi-LASIK group, however, the correlation was much weaker (r = -0.090, P = 0.682; r = 0.093, P = 0.673), although there were no significant differences between LASIK and epi-LASIK groups in postoperative CH (P = 0.730) and CRF (P = 0.736), and in the changes between CH (P = 0.539) and CRF (P = 0.881). Corneal biomechanical changes correlated with AD in LASIK but not in epi-LASIK, and it appeared that patients with identical demographics and similar attempted corrections are more likely to face a greater danger when undergoing LASIK than epi-LASIK. Therefore, the surface ablation procedure was recommended instead of lamellar ablation especially for correcting high myopia from a biomechanical viewpoint.