Comparison between three- and six-month postoperative refractive and visual results after laser epithelial keratomileusis with mitomycin C.

Abstract

To compare the residual refraction and visual results between the three- and six-month postoperative visits to detect the optimal moment for enhancement after myopic laser epithelial keratomileusis (LASEK) with mitomycin C (MMC). Nonrandomized, interventional, prospective study. One hundred and forty-one consecutive eyes that underwent LASEK with MMC to correct their myopia using the Esiris excimer laser (Schwind Eye Tech Solutions, Kleinostheim, Germany), and that showed three months postoperatively a residual defect or a suboptimal uncorrected visual acuity (UCVA) or best spectacle-corrected visual acuity (BSCVA) were included in the study. We compared the residual spherical refraction and cylinder, the UCVA, and the BSCVA between the three- and six-month postoperative examinations. Preoperative spherical refraction was -5.2 +/- 2.90 diopters (D). Preoperative cylinder was -1.66 +/- 1.20 D. The residual sphere was +0.43 +/- 0.90 D three months and +0.21 +/- 0.90 D six months after surgery (P = .0001). The cylinder was -0.71 +/- 0.60 D and -0.67 +/- 0.60 D, respectively (P = .4). The UCVA was 0.75 +/- 0.2 and 0.81 +/- 0.2 (P = .0001) and the BSCVA was 0.94 +/- 0.1 and 1.01 +/- 0.1 (P = .0001), respectively. Those patients with a myopic defect (sphere or cylinder) three months postoperatively did not show any significant change in UCVA or refractive defect six months after surgery, while those with a hyperopic defect (sphere or cylinder) showed an improvement in UCVA and residual refraction six months postoperatively (P < .05). Our results suggest that retreatment after myopic LASEK with MMC may be performed three months after surgery when the residual refraction is myopic, but it seems wise to wait at least six months after surgery when the residual refraction is hyperopic.