No clinical benefit for LASEK over PRK, study finds

Laser epithelial keratomileusis and photorefractive keratectomy provide similar visual acuity results and cause similar levels of pain postoperatively, according to a study in military personnel. No clinical advantage to LASEK over PRK was noted in the study, although the epithelial healing patterns of the two procedures differed.

Amir Pirouzian, MD, and colleagues at the Travis Air Force Base in California prospectively enrolled 30 active-duty military personnel with mild to moderate myopia in a study comparing the two procedures. All patients underwent LASEK in one eye and PRK in the other. Which surgical procedure was first and which eye received which procedure were randomized. Primary outcome measures included subjective pain levels and the rate of corneal epithelial defect recovery. Follow-up was during the first week and up to 30 days postoperatively.

No significant differences were found in subjective pain levels between the two procedures on postop days 1, 2 or 3 or in visual acuity on postop days 3, 7 or 30. A statistically significantly smaller median epithelial defect was seen in the LASEK-treated eyes compared to the PRK-treated eyes on day 1 (P < .001). But by postop day 3, the PRK-treated eyes showed significantly smaller epithelial defects than the LASEK-treated eyes (P < .001). By postop day 7, no epithelial defects were seen in any eyes.

The study is published in the January issue of Archives of Ophthalmology.