A prospective, randomized, contralateral eye comparison of epithelial laser in situ keratomileusis and photorefractive keratectomy in eyes prone to haze.

PURPOSE To compare refractive outcome, subepithelial haze, and pain after epithelial laser in situ keratomileusis (epi-LASIK) and photorefractive keratectomy (PRK). METHODS In this prospective, randomized study, 32 eyes of 16 patients were treated for myopia with epi-LASIK (epi-LASIK group) in one eye and PRK in the fellow eye (PRK group). All patients underwent ablation using the NIDEK EC-5000 CX II excimer laser platform. Mean patient age was 24.8 years (range: 19 to 35 years). Mean preoperative manifest refractive spherical equivalent (MRSE) was -2.76 diopters (D) (range: -1.00 to -4.88 D). Refractive outcome, subepithelial haze, and pain out to 6 months postoperatively were compared between groups. RESULTS At 6 months postoperatively, the mean MRSE was -0.22 +/- 0.27 D (range: 0.25 to -0.88 D) in the epi-LASIK group and -0.23 +/- 0.29 D (range: 0.50 to -1.125 D) in the PRK group. There was no statistically significant difference in the refractive outcomes between groups. By postoperative day 4, 18% of the epi-LASIK group and 7% of the PRK group achieved the final uncorrected visual acuity (UCVA). On day 1 postoperatively, 14% fewer patients in the PRK group experienced pain compared with the epi-LASIK group. On postoperative day 2, 36% fewer patients in the epi-LASIK group experienced pain. Seventy-one percent of patients in the epi-LASIK group and 36% of patients in the PRK group had no haze postoperatively. CONCLUSIONS Epi-LASIK and PRK produced similar refractive outcome. Patients who underwent epi-LASIK experienced faster recovery of vision, less haze, and less pain.