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Photorefractive keratectomy associated with lamellar keratotomy (LASIK) for correction of myopia, with or without drying the stroma

Purpose: To evaluate the clinical results of LASIK for moderate and high degrees of myopia, with and without drying the stroma during photoablation. Patient and Methods: Retrospective analysis of 39 eyes of 30 patients submitted to LASIK, without drying the stroma during photoablation, in the period from April 1996 to April 1997 (Group I) and analysis of 42 eyes of 28 patients with drying of the stromal bed at each 80 pulses during photoablation in the period of April of 1997 to September of 1997 (Group II). After lamellar keratotomy with an automated microkeratome (Chiron Corneal Shaper ®), photoablation with fluoride-argon excimer laser, 193 nm, Summit model Apex Plus ® was carried out. In 2 eyes of the Group I, the photoablation was not possible due to compli- cations during the lamellar keratotomy. Results: The average follow-up was 8.7 months in Group I and 7.7 months in Group II. The mean treatment was -10.81D (±2.38) in Group I and -8.73D (±2.82) in Group II. The average variations of the achieved spherical equivalent in relation to the attempted treatment in months 1, 3, 6 and 12 were respectively, -0.96D (±1.19), -1.19D (±1.37), -1.06D (±1.41) and -1.10D (±0.66) in Group I and -0.23D (±1.02), -0.41D (±1.34), -0.75D (±1.16) and -1.03D (±1.31) in Group II. On the last visit 17 eyes (45.9%) of Group I and 31 eyes (73.8%) of Group II showed uncorrected VA of 20/40 or better. Four intraoperative complications occurred in Group I, in 2 of them the photoablations were not performed and one intraoperative complication occurred in Group II. There was a loss of 2 or more lines in 3 eyes (3.7%) ot Group I. Conclusion: Drying of the stroma led to a faster visual recovery due to smaller hypocorrection. No significant differences were observed in the long-term follow-up.

Myopia surgery; Laser surgery; LASIK


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