Journal of Refractive Surgery

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Original Article 

PRK and Butterfly LASEK: Prospective, Randomized, Contralateral Eye Comparison of Epithelial Healing and Ocular Discomfort

Vinícius C Ghanem, MD; Giselle C Souza, MD; Denise C Souza, MD; Sarah L. P Weber, MD; Juliana M. Z Viese, MD; Newton Kara-José, MD

Abstract

PURPOSE

To compare corneal reepithelialization, pain scores, ocular discomfort, and tear production after photorefractive keratectomy (PRK) and butterfly laser epithelial keratomileusis (LASEK).

METHODS

This prospective, randomized, doublemasked study comprised 102 eyes of 51 patients who underwent laser refractive surgery. Each patient was randomized to have one eye operated on with PRK and the other with butterfly LASEK. Patients were followed for 1 year.

RESULTS

The mean reepithelialization time in the PRK group was 4.35±0.48 days (range: 4 to 5 days) and 4.75±0.72 days (range: 4 to 6 days) in the butterfly LASEK group (P<.002). Pain scores and ocular discomfort were not statistically different between groups, although a trend towards a lower pain level with PRK was noted (3.31±4.09 vs 4.43±4.27; P=.18). Schirmer test values were significantly reduced from preoperative levels through 12 months with both PRK (23.6±8.1 vs 19.4±10.1; P<.002) and butterfly LASEK (22.4±8.7 vs 18.9±9.7; P=.01); however, no difference between groups was noted at any time.

CONCLUSIONS

Photorefractive keratectomy showed a modest but statistically significant shorter reepithelialization time and a tendency towards lower pain scores than butterfly LASEK. The reepithelialization time was strongly associated with the duration of surgery in both techniques. A similar reduction of Schirmer test values was observed up to 1 year postoperatively in both groups. [J Refract Surg. 2008;24:591-599.]

ABOUT THE AUTHORS

From Sadalla Amin Ghanem Eye Hospital (Ghanem, G.C. Souza, D.C. Souza) and the University of Joinville (Viese, Weber), Joinville, Santa Catarina; and the Department of Ophthalmology, University of São Paulo and the State University of Campinas (Kara-José), São Paulo, Brazil.

The authors have no financial or proprietary interest in the materials presented herein.

Correspondence: Vinícius C. Ghanem, MD, Rua Fernando de Noronha, 225 apart. 901, Centro Joinville/SC 89203-072, Brazil. Tel: 55 47 34226010; Fax: 55 47 34228315; E-mail: vcghanem@hotmail.com

Received: December 21, 2006

Accepted: July 6, 2007

Posted online: February 29, 2008

Abstract

PURPOSE

To compare corneal reepithelialization, pain scores, ocular discomfort, and tear production after photorefractive keratectomy (PRK) and butterfly laser epithelial keratomileusis (LASEK).

METHODS

This prospective, randomized, doublemasked study comprised 102 eyes of 51 patients who underwent laser refractive surgery. Each patient was randomized to have one eye operated on with PRK and the other with butterfly LASEK. Patients were followed for 1 year.

RESULTS

The mean reepithelialization time in the PRK group was 4.35±0.48 days (range: 4 to 5 days) and 4.75±0.72 days (range: 4 to 6 days) in the butterfly LASEK group (P<.002). Pain scores and ocular discomfort were not statistically different between groups, although a trend towards a lower pain level with PRK was noted (3.31±4.09 vs 4.43±4.27; P=.18). Schirmer test values were significantly reduced from preoperative levels through 12 months with both PRK (23.6±8.1 vs 19.4±10.1; P<.002) and butterfly LASEK (22.4±8.7 vs 18.9±9.7; P=.01); however, no difference between groups was noted at any time.

CONCLUSIONS

Photorefractive keratectomy showed a modest but statistically significant shorter reepithelialization time and a tendency towards lower pain scores than butterfly LASEK. The reepithelialization time was strongly associated with the duration of surgery in both techniques. A similar reduction of Schirmer test values was observed up to 1 year postoperatively in both groups. [J Refract Surg. 2008;24:591-599.]

ABOUT THE AUTHORS

From Sadalla Amin Ghanem Eye Hospital (Ghanem, G.C. Souza, D.C. Souza) and the University of Joinville (Viese, Weber), Joinville, Santa Catarina; and the Department of Ophthalmology, University of São Paulo and the State University of Campinas (Kara-José), São Paulo, Brazil.

The authors have no financial or proprietary interest in the materials presented herein.

Correspondence: Vinícius C. Ghanem, MD, Rua Fernando de Noronha, 225 apart. 901, Centro Joinville/SC 89203-072, Brazil. Tel: 55 47 34226010; Fax: 55 47 34228315; E-mail: vcghanem@hotmail.com

Received: December 21, 2006

Accepted: July 6, 2007

Posted online: February 29, 2008

10.3928/1081597X-20080601-07

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