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, Gwan

gju, Republic of Korea 2

• Dr. Koh• Dr. Kim• Dr. Yoon

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

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

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)

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) >> 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).

Mean Spherical Equivalents

• Spherical equivalent of

myopia

: stabilized in all groups

• No significant regression

in all groups

• In the analysis of

correlation between the 4

groups

: No significant difference

(P = 0.305)

Mean Keratometry

• Mean corneal curvatures

: stabilized in all groups

• In the analysis of correlation

between the 4 groups

: No significant change

(P = 0.128)

Corneal Haziness

• 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

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

Subjective Pain & Satisfaction scores

• Numeric Pain Intensity

Scale (0–10)

: On-flap (Groups I & II) >>

>> 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)

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