Abstract

PEREZ SUAREZ, Raúl Gabriel et al. Epilasik versus Lasek with optimized refractive keratectomy and topography-customized ablation. Rev Cubana Oftalmol [online]. 2010, vol.23, n.1, pp. 15-26. ISSN 1561-3070.

OBJECTIVE: To assess the effectiveness of Excimer laser surgery, using either epithelial laser in situ keratomileusis (Epilasik) or laser-assisted epithelial keratectomy as surgical techniques, on the basis of a topoaberrometric study of patients with compound myopic astigmatism. METHODS: A prospective study was conducted in the Anterior Segment Service of "Camilo Cienfuegos" International Center of Pigmentary Retinitis. Eighty eyes from 40 patients with compound myopic astigmatism (-1 to -6 dioptres) were studied, with a minimal follow-up of 6 months. Visual acuity without correction, keratometry, dynamic refraction, cycloplexic refraction, corneal topography, pachymetry, tonometry, biomicroscopy, study of the tear and funduscopy were all evaluated. The corneal waterfront analysis software was used for all the cases. Lasek was the chosen technique for right eyes whereas Epilasik was used for left eyes, using optimized refractive keratectomy in both procedures. RESULTS: In those cases treated with Lasek technique, visual acuity without correction changed from 0,12 to 0,93; preoperative sphere average changed -2,77 to -0,08 dioptres at the postoperative phase, the cylinder went from -79 to -0,37 dioptres, spheral aberration at 6mm slightly changed from 0,22 to 0,24 um and the coma varied from 0,19 to 0,20 um. In the cases subjected to Epilasik, visual acuity without correction varied from 0,07 to 0,93; the preoperative sphere average modified from -3,79 to 0,01 dioptres in the postoperative period, the cylinder went from -1,25 to -0,35 dioptres, spheral aberration at 6mm changed from 0,26 to 0,39 um, and the coma varied from 0,19 to 0,22 um. As to confocal microscopy, it was observed that recovery was faster in cases operated on with Epilasik technique. CONCLUSIONS: The improvement in visual acuity was statistically significant in both techniques and the decrease in the average sphere and cylinder was very similar; however, the variation in the spheral aberration and the coma was not significant. From the anatomical viewpoint, the eyes operated on by the Epilasik technique recovered more rapidly.

Keywords : Topoaberrometry; myopia; Epilasik; Lasek.

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