Comparison of laser epithelial keratomileusis and photorefractive keratectomy for the correction of myopia: a meta-analysis

Background It is unclear whether a laser epithelial keratomileusis （LASEK） has any significant advantage over a photorefractive keratectomy （PRK） for correcting myopia. We undertook this meta-analysis of randomized controlled trials to examine possible differences in efficacy, accuracy, safety and side-effects between two methods, LASEK and PRK, for correcting myopia. Methods A systematic literature retrieval was conducted in the PubMed, EMBASE, Chinese Bio-medicine Database, and Cochrane Controlled Trials Register to identify potentially relevant randomized controlled trials. The statistical analysis was performed using a RevMan 4.2 software. The results included efficacy outcomes （proportion of eyes with uncorrected visual acuity （UCVA）〉 20/20 at 1 month and 12 months post-treatment）, accuracy outcomes （proportion of eyes within ±0.50 diopters （D） of target refraction at 1 month and 12 months post-treatment）, safety outcomes （loss of 〉2 lines of best spectacle-corrected visual acuity （BSCVA） at 〉 6 months post-treatment）, mean pain scores on day 1 post-treatment, and mean corneal haze scores at 6 and 12 months post-treatment. Results Seven articles describing a total of 604 eyes with myopia from 0 to -9.0 D were identified in this meta-analysis. The combined results showed that the efficacy and accuracy outcomes between the two groups at 1 month and 12 months post-treatment were comparable. No patient lost 〉 2 lines of BSCVA at 〉 6 months post-treatment in four relevant trials. Compared with PRK, LASEK did not relieve discomfort on day 1 post-treatment or reduce corneal haze intensity at 6 and 12 months post-treatment. Conclusions According to the available data, LASEK does not appear to have any advantage over PRK for correcting myopia from 0 to -9.0 D. This meta-analysis focuses mainly on the comparison of the early, mid-term and mid-long term results of the two methods. Additional studies to compare the long-term （〉one year） results should be considered.

Comparison of laser epithelial keratomileusis and photorefractive keratectomy for the correction of myopia: a meta-analysis

Background It is unclear whether a laser epithelial keratomileusis (LASEK) has any significant advantage over a photorefractive keratectomy (PRK) for correcting myopia.We undertook this meta-analysis of randomized controlled trials to examine possible differences in efficacy,accuracy,safety and side-effects between two methods,LASEK and PRK,for correcting myopia.Methods A systematic literature retrieval was conducted in the PubMed,EMBASE,Chinese Bio-medicine Database,and Cochrane Controlled Trials Register to identify potentially relevant randomized controlled trials.The statistical analysis was performed using a RevMan 4.2 software.The results included efficacy outcomes (proportion of eyes with uncorrected visual acuity (UCVA)≥ 20/20 at 1 month and 12 months post-treatment),accuracy outcomes (proportion of eyes within ±0.50 diopters (D) of target refraction at 1 month and 12 months post-treatment),safety outcomes (loss of ≥2 lines of best spectacle-corrected visual acuity (BSCVA) at ≥ 6 months post-treatment),mean pain scores on day 1 post-treatment,and mean corneal haze scores at 6 and 12 months post-treatment.Results Seven articles describing a total of 604 eyes with myopia from 0 to -9.0 D were identified in this meta-analysis.The combined results showed that the efficacy and accuracy outcomes between the two groups at 1 month and 12 months post-treatment were comparable.No patient lost ≥ 2 lines of BSCVA at ≥ 6 months post-treatment in four relevant trials.Compared with PRK,LASEK did not relieve discomfort on day 1 post-treatment or reduce corneal haze intensity at 6 and 12 months post-treatment.Conclusions According to the available data,LASEK does not appear to have any advantage over PRK for correcting myopia from 0 to -9.0 D.This meta-analysis focuses mainly on the comparison of the early,mid-term and mid-long term results of the two methods.Additional studies to compare the long-term (＞one year) results should be considered.