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    LASIK, PRK enhancements yield similar safety, efficacy, predictability

    Postoperative higher-order aberrations also appear to be comparable between two groups

    Used as an enhancement after refractive surgery, wavefront-guided LASIK and wavefront-guided PRK result in similar outcomes, according to Lisa Y. Chen, MD.

    “We found that LASIK and PRK resulted in similar improvements in uncorrected distance visual acuity [UDVA],” said Dr. Chen, clinical instructor, Department of Ophthalmology, Stanford University, Stanford, CA. “Both procedures were safe, resulting in no adverse outcomes.”

    Previous studies have found similar outcomes in LASIK and PRK as a primary treatment for refractive error. But few prospective trials compare the two procedures as enhancement surgery, she noted.

    Dr. Chen and co-author, Edward E. Manche, MD, followed 34 eyes of 30 patients whose prior refractive surgery had left them with residual refractive error. Eyes had a mean spherical equivalent power of -0.36 D (range -1.125 to 1.625 D) and a mean cylinder of 0.53 D (range 0 to 1.25 D).

    They re-treated 12 eyes with wavefront-guided LASIK and 22 eyes with wavefront-guided PRK using an excimer laser (AMO VISX S4 CustomVue IR, Johnson & Johnson Vision).

     

    Making the decision

    “The decision whether to perform a LASIK or PRK enhancement was determined by the type of original refractive surgery the patient underwent and the amount of time since the initial procedure,” Dr. Chen said.

    Most patients had chosen LASIK as their primary treatment due to increased familiarity with the procedure and the greater speed and ease of recovery, Dr. Chen said.

    The majority of these patients underwent LASIK enhancements, with the exception of those whose primary treatment occurred more than 1 year ago due to the increased risk of epithelial ingrowth with late enhancements.

    Avoiding epithelial ingrowth

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