Clinical outcomes of Epi-LASIK : 1-Year-Long Results of Flap ON/OFF with Mitomycin-C ON/OFF

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Clinical outcomes of Epi-LASIK 1-Year-Long
Results of Flap ON/OFF with Mitomycin-C ON/OFF

• Gil-Joong Yoon (MD/PhD) 1 Seong-Taeck Kim (MD)2
  Jae-Woong Koh (MD/PhD)2

Happy Eye Clinic, Gwangju, Republic of Korea
1 Department of Ophthalmology, Chosun University
College of Medicine, Gwangju, Republic of Korea 2
2

• Dr. Koh

• Dr. Kim

• Dr. Yoon

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Purpose

• To evaluate and compare of Clinical outcomes of
  epi-LASIK
• On-flap vs Off-flapWith 0.02 Mitomycin-C (MMC)
  vs Without MMC
• Uncorrected visual acuity (UCVA)Spherical
  equivalent refractionKeratometryCorneal
  hazinessSubjective Pain scoresSubjective
  Satisfaction scores

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Methods

• Nonrandomized comparative retrospective study
• 198 patients (394 eyes) had undergone an
  epi-LASIKfor myopia (-1.5D to -8.0D spherical
  equivalent) correction
• Group I on-flap without MMC (181 eyes)Group II
  on-flap with MMC (52 eyes)Group III off-flap
  without MMC (93 eyes)Group IV off-flap with
  MMC (68 eyes)
• Outcomes POD 1 day / 1 mo / 3 mo / 6 mo / 1
  year

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Baseline Characteristics of eyes for Epi-LASIK
surgery

• epi-LASIK epi-laser in-situ keratomileusis
  SD standard deviation
• SE spherical equivalent
  D diopters

• Mean central corneal thicknesses - No
  statistical significant difference between the 4
  groups (P 0.131)
• Mean corneal curvature measured- No statistical
  significant difference between the 4 groups (P
  0.525)

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Mean Uncorrected Visual Acuities

• (A) 1 day (B) 1 month (C) 6 month (D) 12 month

• 20/25 20/20 and more (A) 10 (I) / 8 (II)
  / 29 (III) / 27 (IV)Off-flap (Groups III and
  IV) gtgt On-flap (Groups I and II) (P 0.002)
• Changes in UCVA for any of the groups No
  statistically significance at (B),(C),(D) (P
  0.272, P 0.514, P 0.643).

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Mean Spherical Equivalents

• Spherical equivalent of myopia stabilized in
  all groups
• No significant regressionin all groups
• In the analysis of correlation between the 4
  groups No significant difference (P 0.305)

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Mean Keratometry

• Mean corneal curvatures stabilized in all
  groups
• In the analysis of correlation between the 4
  groups No significant change (P 0.128)

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Corneal Haziness
(A) 1 day (B) 1 month (C) 6 month (D) 12 month

• Percentages in every grade of opacity for any of
  the groups- No statistically significant at all
  periods (P 0.533)- No affected by On- or
  Off-flap methods or by MMC use or non-use

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Subjective Pain Satisfaction scores

• Numeric Pain Intensity Scale (010) On-flap
  (Groups I II) gtgtgtgt Off-flap (Groups III IV)
  (P 0.010)
• Grades of patient satisfaction (0-10) No
  significant differences between any of the
  groups (P 0.248)

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Conclusions

• Myopic correction by Epi-LASIK surgery- Stable
  visual results in 1-year postop. outcomes
• Off-flap method - Faster visual recovery- Less
  postoperative pain
• 0.02 MMC - Less effective than that expected
  for corneal haziness levels