Long-Term Outcomes After LASIK: Mechanical Microkeratome Versus Femtosecond Laser
Purpose
To evaluate the long-term outcomes of patients who underwent myopic LASIK and analyze the differences between flaps created by mechanical microkeratome and femtosecond laser.
Methods
In this prospective study, 90 eyes of 47 patients who underwent myopic LASIK from 2003-2004 were enrolled to participate eight to ten years after their surgery. Best-corrected visual acuity, slit-lamp examination, and corneal topography were assessed. Visual-related quality of life was evaluated using the National Eye Institute Refractive Error Quality of Life (NEI-RQL)-42 questionnaire. We also collected data from preoperative and postoperative time points: 1 day, 1 month, 3 months, and one year. P-value less than 0.05 was considered statistically significant. This study was approved by the Institutional Review Board and informed consent was collected from participants.
Results
The mean age was 52.1-years-old. Flap creation was performed with mechanical microkeratome in 47 (52.2%) of the eyes and with femtosecond laser in 43 (47.8%) eyes. Preoperative best-corrected visual acuity was 20/17 in both the microkeratome and femtosecond laser groups (p=0.676). At the study visit, uncorrected visual acuity was 20/26 and 20/24 (p=0.779), and best-corrected visual acuity was 20/18 and 20/19 (p=0.731) (microkeratome and femtosecond groups, respectively). Corneal topography showed no statistical significance in flat curvature (p=0.156), but was significant in steep curvature (p=0.043) when compared with microkeratome and femtosecond. The NEI-RQL-42 questionnaire had no statistical significance between groups.
Conclusion
This study reveals similarities between the long-term vision outcomes of LASIK surgery with mechanical microkeratome and femtosecond laser. Despite differences on final corneal topography, the uncorrected and best-corrected visual acuity and visual-related quality of life had no differences.