Laser-Assisted Subepithelial Keratectomy versus Laser In Situ Keratomileusis in Myopia: A Systematic Review and...

Area of Science:

• Ophthalmology
• Refractive Surgery
• Corneal Surgery

Background:

• Myopia management is a significant area of ophthalmological research.
• Laser refractive surgeries like LASEK and LASIK are common treatments for myopia.
• Comparing the long-term efficacy and safety of different refractive surgical techniques is crucial.

Purpose of the Study:

• To systematically review and compare clinical outcomes of LASEK versus LASIK for myopia correction.
• To evaluate differences in visual acuity, refractive error, and complication rates between LASEK and LASIK.
• To assess the long-term efficacy and safety profiles of both procedures.

Main Methods:

• Systematic review of 12 clinical controlled trials.
• Comparison of LASEK (780 eyes) and LASIK (915 eyes).
• Analysis of primary outcomes: MRSE, MRSE within ±0.50 D, UCVA ≥20/20, loss of ≥1 line BCVA; secondary outcomes: flap complications, corneal haze.

Main Results:

• No significant differences in visual and refractive outcomes for low to moderate myopia.
• Higher incidence of BCVA loss with LASEK for moderate to high myopia in mid- to long-term follow-up.
• Increased corneal haze and regression observed with LASEK for moderate to high myopia.
• Flap complications occurred in LASIK but not significantly more than LASEK.
• LASEK showed a worsening trend in efficacy (MRSE, UCVA) long-term.

Conclusions:

• LASEK and LASIK are safe and effective for low to moderate myopia.
• LASIK may offer better long-term visual stability for moderate to high myopia due to less regression and haze.
• LASEK avoids flap-related complications inherent to LASIK, but stromal haze and regression impact its efficacy in higher myopia.