Comparative analysis of subjective and objective visual quality after LASEK, FS-LASIK, and TransPRK

The objective of this study was to compare subjective and objective visual quality after three types of corneal refractive surgery (LASEK, FS-LASIK, and TransPRK). 150 patients (300 eyes) who underwent corneal refractive surgery were divided into three groups comprised of 45 patients (90 eyes) in the LASEK group, 55 patients (110 eyes) in the FS-LASIK group, and 50 patients (100 eyes) in the TransPRK group. Subjective evaluation included uncorrected distance visual acuity (UDVA), recorded in decimal notation, and the Quality-of-Life Impact of Refractive Correction (QIRC) questionnaire. Objective optical quality was measured with the OQAS II double-pass analyzer (Visiometrics, Spain) in 50 eyes per group. All three surgical procedures-LASEK, FS-LASIK, and TransPRK-significantly improved overall UDVA from baseline. At 6 months postoperatively, UDVA after LASEK and FS-LASIK was significantly higher than at 1 month, and UDVA at 1 month was significantly better than preoperative levels (P < 0.05). At 1 month, UDVA was significantly better after TransPRK than after LASEK or FS-LASIK, but this difference was no longer present at 6 months. At 6 months, QIRC scores were significantly higher than preoperative values after FS-LASIK (P = 0.004) and TransPRK (P = 0.016), whereas the increase after LASEK was not significant (P = 0.157). All procedures were associated with improvements in subjective and objective visual quality measures; however, no statistically significant differences were observed among the three surgical techniques at six months. Objective optical quality indices were within the normal range in all three groups at 6 months and did not differ significantly between techniques. All procedures (LASEK, FS-LASIK, and TransPRK) were associated with improvements in subjective and objective visual quality and quality of life; however, no statistically significant differences were observed among the three surgical techniques at six months postoperatively.