A Comparison of Visual Outcomes and Patient Satisfaction Between Photorefractive Keratectomy and Femtosecond Laser-Assisted In Situ Keratomileusis

Abstract

PurposeTo compare visual outcomes and satisfaction among patients of photorefractive keratectomy (PRK; Wavelight EX 500, Alcon, Ft Worth, TX, USA) and femtosecond laser-assisted in situ keratomileusis (FAL; Wavelight FS 200 laser and Wavelight EX 500, Alcon, Ft Worth, TX, USA).MethodsWe performed a retrospective study of 409 eyes in 207 patients that underwent either PRK (n=90) or FAL (n=117) at the two centers of Hashmanis Hospital, Karachi, Pakistan. The included refractive outcomes were sphere diopters (D), cylinder D, and spherical equivalent D. Additionally, visual acuities were included. All of these were assessed preoperatively and at the one-month postoperative check-up. Patient satisfaction was gauged at the time of chart review by contacting the patient.ResultsWhen looking at the postoperative outcomes, we found all values to be statistically significant (p<0.001) with superior outcomes in the FAL cohort. Additionally, 90% and 15% of eyes achieved a postoperative uncorrected visual acuity (UCVA) of 20/20 in FAL and PRK, respectively. Furthermore, the efficacy indexes of the FAL and PRK arms were 1.00 and 0.82, respectively. The predictability of the procedures were 92.1% and 64.9%, respectively. Lastly, 93.3% of patients were satisfied with FAL and 95.7% with PRK.ConclusionOur study shows superior visual outcomes in patients undergoing FAL. However, we found a higher satisfaction rate in those that underwent PRK, perhaps due to the higher cost of FAL.

Laser Assisted In Situ Keratomileusis (Lasik) Versus Trans Epithelial Photorefractive Keratectomy (T-Prk) In Astigmatic Patients

“…In a local study from Pakistan, although superior visual outcomes were reported with LASIK but patients satisfaction rate was higher in simple PRK due to the higher cost of LASIK. 19 In T-PRK and LASIK, the difference in the cost is not very much. Hence, satisfaction level of the patient is related with the visual outcome as compared to the cost.…”

Long Term Follow-Up Safety and Effectiveness of Myopia Refractive Surgery

“…The use of mitomycin C on the stromal bed after ablation has allowed PRK surgeries in patients with high myopia by avoiding the appearance of haze in the postoperative period [ 8 , 9 , 17 ]. Less postoperative pain, fast visual recovery, and minimal incidence of haze has made FS-LASIK the preferred procedure in refractive surgery [ 18 ].…”

“…The number of FS-LASIK procedures has increased and surpasses the number of PRK procedures owing to faster visual recovery, less pain, and better ametropic range capability compared to following the former procedure [ 16 , 17 , 18 ]. PRK is still performed today, especially in corneas with superficial scarring, for epithelial dystrophies or recurrent erosions, in thin corneas, after penetrating keratoplasty, and for refractive retreatments.…”

“…Continued analysis of the safety and effectiveness of these procedures is highly relevant [ 18 ] and necessary to informed consent and evidence-based clinical practice in refractive surgery. We conducted a retrospective non-randomized analysis of the outcomes to determine the safety, predictability, and effectiveness of performing PRK or FS-LASIK after ten years.…”

Visual and Refractive Outcomes of Topography-guided Laser-assisted In Situ Keratomileusis in Virgin Eyes

“…The study protocol [ 11 , 12 ] and reasons for exclusion [ 13 ] have been discussed in previous studies. Included in the study were patients aged 18 years or over who sought LASIK eye surgery for spectacle independence.…”