Photorefractive keratectomy (PRK) versus laser assisted in situ keratomileusis (LASIK) for hyperopia correction

Settas, George; Settas, C; Minos, Evangelos; Yeung, Ian

doi:10.1002/14651858.cd007112.pub2

Cited by 9 publications

(12 citation statements)

References 7 publications

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“…These surgical options include laser-assisted in situ keratomileusis (LASIK), photorefractive keratectomy, or phakic intraocular lens implantation. 3 Femtosecond lenticule extraction (FLEx) is a relatively new refractive surgery procedure in which a femtosecond laser is used to create an intrastromal lenticule that is removed after lifting the flap, as first described in 2006. 4 , 5 The FLEx procedure was further modified by eliminating the need for a flap by dissecting and extracting the lenticule through a small incision, known as a small incision lenticule extraction (SMILE).…”

Section: Introductionmentioning

confidence: 99%

Higher-Order-Aberrations Following Hyperopia Treatment: Small Incision Lenticule Extraction, Laser-Assisted In Situ Keratomileusis and Lenticule Implantation

Liu

Wen

Teo

et al. 2018

Trans. Vis. Sci. Tech.

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PurposeTo compare the postoperative higher-order-aberrations (HOAs) after hyperopic small incision lenticule extraction (SMILE), hyperopic laser-assisted in situ keratomileusis (LASIK), and lenticule implantation for correction of hyperopia.MethodsEighteen monkeys were divided to six groups: +2.00 D and +4.00 D hyperopic SMILE, +2.00 D and +4.00 D hyperopic LASIK (n = 6 eyes for each), and lenticule implantation with a −2.00 D and −4.00 D lenticule (n = 3 eyes for each). The corneal HOAs were evaluated preoperatively and 3-month postoperatively.ResultsAt 3-month postoperatively, the spherical aberrations significantly increased toward negative direction in all +4.00 D groups (all P < 0.05). There was a significant change toward more negative values in the third-order vertical coma in the SMILE +4.00 D and LASIK +4.00 D groups (P = 0.026 and P = 0.036, respectively). There were also significant changes in the third-order horizontal trefoil (P = 0.034) and oblique secondary astigmatism (P = 0.012) in the LASIK +4.00 D group. In the eyes that underwent +4.00 D lenticule implantation, the fourth-order horizontal quatrefoil significantly increased (P = 0.029). In low hyperopia correction (+2.00 D), treatment with lenticule implantation tended to have less changes in HOAs, compared to the other two groups.ConclusionsIn hyperopic SMILE, hyperopic LASIK or lenticule implantation surgery, significant induction of third- and fourth-order HOAs were seen in moderate hyperopia correction but not in low hyperopia correction. In low hyperopia treatment, lenticule implantation might offer a favorable trend in the aspect of HOAs.Translational RelevanceThe results provided the knowledge of surgically induced HOAs and understanding of the effects of surgery in different types of hyperopic correction.

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Section: Introductionmentioning

confidence: 99%

Higher-Order-Aberrations Following Hyperopia Treatment: Small Incision Lenticule Extraction, Laser-Assisted In Situ Keratomileusis and Lenticule Implantation

Liu

Wen

Teo

et al. 2018

Trans. Vis. Sci. Tech.

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“…However, PRK is not very desirable in hyperopic ablation as it has a risk of peripheral corneal scarring, haze, and hyperopic regression [9, 10]. On the other hand, LASIK has been shown to lead to satisfactory results in hyperopia and hyperopic or mixed astigmatism [11], and when compared to photorefractive keratectomy (PRK) for hyperopia, LASIK was also associated with a faster stabilization of refraction, less pain [12], and less hyperopic regression, but comparable efficacy [13].…”

Section: Introductionmentioning

confidence: 99%

Under-the-Flap Crosslinking and LASIK in Early Ectasia with Hyperopic Refractive Error

El‐Khoury

Abdelmassih

Amro

et al. 2018

Journal of Ophthalmology

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Purpose To present safety, efficacy, and early results of a new combinational treatment for early corneal ectasia with hyperopic refractive error aimed to reinstate emmetropia and stabilize cornea. Method This is a retrospective case series. All surgeries were performed at the Beirut Eye Specialist Hospital, Lebanon. Surgical procedure consisted of (1) lifting flap (post-LASIK ectasia)/creation of corneal flap (keratoconus), (2) application of excimer laser ablation to correct refractive error, (3) loose repositioning of flap, (4) under-the-flap irrigation with riboflavin 0.1% dextran solution, and (5) application of UVA light. Results A total of 7 eyes (4 patients; mean age 24.25 years; all male) were included. 2 patients had early keratoconus, and 2 patients had early post-LASIK ectasia. Pretreatment vs. last postoperative follow-up visit (mean 11.25 months; range 6–15 months) UDVA (logMAR), spherical equivalent (SE) (D), astigmatism (D), and central pachymetry (µm) were 0.35 ± 0.18 vs. 0.05 ± 0.07, p=0.017; −0.81 ± 0.67 vs. −0.46 ± 0.57, p=0.078; 2.46 ± 0.53 vs. 0.68 ± 0.28, p=0.018; and 547 ± 58 vs. 536 ± 49, p=0.07, respectively. In all eyes, BCVA was 0.1 logMAR or better before and after treatment. No eye showed a decrease in BCVA. Two eyes of one patient had an epithelial ingrowth, which was removed in one case. Follow-up results showed no major complications and no progression of corneal ectasia. Conclusion Early results showed that under-the-flap CXL with excimer laser correction is an effective treatment for early hyperopic keratectasia, with the advantage of rapid recovery, postoperative corneal stability, and no epithelial healing complications. The procedure seems to bear a risk for postoperative epithelial growth into the flap interface.

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“…With regard to hyperopic surface excimer laser treatments, clinical studies using large diameter, greater than 6.50 mm optical zone ablations with modern laser platforms report excellent efficacy and safety indices, albeit with early overcorrection and delayed post‐operative refractive stabilisation of up to three to six months . There is a paucity of RCTs . In a recent Cochrane review no suitable RCTs comparing hyperopic PRK and LASIK could be identified; however, analysis of non‐randomised trials showed comparable efficacy.…”

Section: Surface Versus Flapmentioning

confidence: 99%

“…There is a paucity of RCTs . In a recent Cochrane review no suitable RCTs comparing hyperopic PRK and LASIK could be identified; however, analysis of non‐randomised trials showed comparable efficacy.…”

Section: Surface Versus Flapmentioning

confidence: 99%

Excimer laser surface ablation: a review of recent literature

O’Brart

2014

Clinical and Experimental Optometry

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The aim was to review the recently published literature on excimer laser surface ablation procedures, including photorefractive keratectomy (PRK), laser sub-epithelial keratomileusis (LASEK), microkeratome-assisted PRK (epi-LASIK) and trans-epithelial (laser-assisted) PRK, to help elucidate where and how surface ablation may best fit into current refractive surgical practice. The emphasis was on publications within the last three years and included systemic reviews, meta-analyses and randomised controlled trials. Where such evidence did not exist, selective large series cohort studies, case-controlled studies and case series with follow-up preferably greater than six months were examined and included. Refractive and visual outcomes are excellent and comparable to those after LASIK even in complex cases after previous corneal surgery. Indeed, surface ablation combined with corneal collagen cross-linking may be used in selected eyes with biomechanical instability, where LASIK is contraindicated. In addition, there is evidence to suggest that there may be less induction of higher order aberrations with surface techniques. Long-term stability and safety appear to be extremely satisfactory. The literature supports the use of modern excimer laser surface treatments, with outcomes comparable to those after LASIK and evidence of less induction of higher-order aberrations. Follow-up studies at 10 to 20 years indicate excellent stability and safety.

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Photorefractive keratectomy (PRK) versus laser assisted in situ keratomileusis (LASIK) for hyperopia correction

Abstract: No robust, reliable conclusions could be reached, but the non-randomised trials reviewed appear to be in agreement that hyperopic-PRK and hyperopic-LASIK are of comparable efficacy. High quality, well-planned open RCTs are needed in order to obtain a robust clinical evidence base.

Cited by 9 publications

References 7 publications

Higher-Order-Aberrations Following Hyperopia Treatment: Small Incision Lenticule Extraction, Laser-Assisted In Situ Keratomileusis and Lenticule Implantation

Higher-Order-Aberrations Following Hyperopia Treatment: Small Incision Lenticule Extraction, Laser-Assisted In Situ Keratomileusis and Lenticule Implantation

Under-the-Flap Crosslinking and LASIK in Early Ectasia with Hyperopic Refractive Error

Excimer laser surface ablation: a review of recent literature

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