Comparison of LASIK and Mitomycin-C Assisted LASEK for Correction of Refractive Errors After Cataract Surgery - PowerPoint PPT Presentation

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Comparison of LASIK and Mitomycin-C Assisted LASEK for Correction of Refractive Errors After Cataract Surgery

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Title: Comparison of LASIK and Mitomycin-C Assisted LASEK for Correction of Refractive Errors After Cataract Surgery


1
Comparison of LASIK and Mitomycin-C Assisted
LASEK for Correction of Refractive Errors After
Cataract Surgery
  • Dr. Nitin Balakrishnan,
  • Crystal Vision Laser Centre, Mumbai, India.
  • Dr. Shilpa Kodkany,
  • Dr. Kodkanys Eye Care Centre, Belgaum, India..

No author has any financial or proprietary
interest in any materials or methods mentioned
2
PURPOSE
  • To compare the results of Laser in situ
    keratomileusis (LASIK) Mitomycin C assisted,
    Laser subepithelial keratomileusis (LASEK), to
    correct residual refractive errors following
    cataract surgery.
  • DESIGN
  • Dual centre, comparative, retrospective
    study.

3
METHODS
  • Nineteen Patients (20 eyes) - 10 males 9
    females had LASIK.
  • Nineteen Patients (19 eyes) - 8 males 11
    females had LASEK.
  • Patients Age varied from 51 to 66 years.
  • Interval between Cataract Surgery and Refractive
    procedure 3 to 36 months(mean 14 months).
  • All Patients had Phakoemulsification with In the
    Bag IOL implants.
  • Pre-op Spherical Equivalent Refraction (SEQ) -
    4 to 5 Diopters..

4
METHODS
  • LASEK
    performed with 20 alcohol, for Mechanical
    Epithelial Debridement.
  • Ablated bed treated
    with 0.02 Mitomycin C for 90 seconds
  • LASIK flap made with Moria
    MII microkeratome, with a thickness of 130 or 90
    microns.
  • Wavelight Allegreto eximer laser was used for
    all patients.
  • With repetition rate of 200 Hz optical zone of
    6 or 6.5mm.
  • Eyes with tracking difficulties were excluded.
  • Uncorrected Visual Acuity (UCVA),Best
    Spectacle-corrected Visual Acuity(BSCVA),
    percentage of eyes within Half diopter (D) of
    targeted refraction, targeted v/s achieved
    spherical equivalent correction and gain/ loss in
    Snellens lines were compared between the two
    groups.
  • Length of follow up - 6 months

5
RESULTS - UCVA
Percentage of eyes with UCVA 20/20
Postoperative period (months)
Mean UCVA better in the LASIK group from 1 4
months
No significant difference in mean UCVA at 6
months
6
RESULTS - BSCVA
Percentage of eyes with BSCVA 20/20
Postoperative period (months)
Mean BSCVA better in the LASIK group from 1 to
3 months
No significant difference in mean BSCVA from 4 to
6 months
7
RESULTS - Post op Spherical Equivalent Refraction
- 6 months
Percentage of eyes
Post op Spherical Equivalent Refraction in D
8
RESULTS - Percentage of eyes within 0.5D of
Targeted Refraction
9
RESULTS - Targeted v/s Achieved Spherical
Equivalent Refraction(LASIK) Group
20 eyes
Targeted
10
Targeted v/s Achieved Spherical Equivalent
Refraction(LASEK) Group
19 eyes
11
RESULTS - CHANGE IN SNELLENS LINES OF BCVA
Percentage of eyes
No eyes lost 2 or more Snellens lines of BCVA
6 eyes gained 1 Snellens line of BCVA in Both
groups
2 eyes gained 2 Snellens lines of BCVA in LASIK
group v/s 1 eye in LASEK group
12
CONCLUSIONS
  • Both Mitomycin C assisted LASEK and LASIK
    effective in correcting post Cataract residual
    refractive errors.
  • Short term superiority of LASIK over LASEK in
    the immediate post-op period.
  • Equally good refractive correction at 6 months
  • Gain in Snellens lines in BCVA, almost equal in
    both groups.
  • Subepithelial Haze in LASEK group significantly
    less due to Mitomycin C , which decreased from
    Grade I in first 2 months to lt grade 0.5 at 6
    months.
  • Longer term studies required to determine
    refractive stability of the two procedures.

REFERENCES 1.Ahn CS, et al. Initial results of
PRK LASIK performed by a single surgeon. J Cat
Ref Surg 1999251048-1055 2.Steinert RF, et al.
Surgical correction of moderate myopia. II, PRK
LASIK are the treatments of choice. Surv Ophthal
199843157-179 3.Ayala MJ, et al. LASIK to
correct residual myopia after cataract surgery. J
Refract Surg 2001 17 12-16 4.Sanchez-Galeana
CA, et al. LASIK PRK for residual ref error
after phakic IOL implantation. J Refract Surg
200117299-304 5.Guell JL, et al. LASIK for
correction of residual ref errors from previous
surgical procedures. Ophthalmic Surg Lasers
199930341-349 6. Artola A, et al. PRK for
residual myopia after cataract surgery. J Cat Ref
Surg 1999251456-1460 7.El Danasoury MA, et al.
Comparison of PRK with LASIK in correcting low
myopia a randomised study. Ophthalmology
1999106 411-420 8.El-Maghraby A, et al.
Randomised bilateral comparison of LASIK and
PRKfor 2.5 to 8 D of myopia. 1999106447-457
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