Clinical Ophthalmology (May 2017)
Comparison of visual acuity, refractive outcomes, and satisfaction between LASIK performed with a microkeratome and a femto laser
Abstract
Sharif Hashmani,1 Nauman Hashmani,1 Hina Rajani,2 Priyanka Ramesh,2 Junaid Ahmed Soomro,2 Syed Rashid Hussain Shah,2 Jaish Kumar,2 Sayed Mustafa Mahmood Shah2 1Department of Ophthalmology, Hashmanis Hospital, Karachi, Pakistan; 2Dow Medical College, Karachi, Pakistan Purpose: To compare refractive outcomes, visual acuities, and satisfaction of patients between those treated with laser-assisted in situ keratomileusis (LASIK) using a Hansatome microkeratome (HM) and femto-assisted laser (FAL).Methods: This was a retrospective analysis of 1,366 eyes in 687 patients who underwent LASIK with an HM (n=1,137) and an FAL (n=229) at the two centers of Hashmanis Hospital, Karachi, Pakistan. Refractive outcomes, including sphere, cylinder, and spherical equivalent in diopters (D), and visual acuities were assessed both preoperatively and at 1 month follow-up. Patient satisfaction was gauged by contacting the patient at the time of chart review.Results: The postoperative median sphere, cylinder, and spherical equivalent values for those treated with FAL were 0.3±0.7 (-5.5–1.8), -0.5±0.6 (-5.0–1.0), and 0.0±0.7 (-6.0–1.6), respectively. For the HM arm, they were 0.0±1.28 (-10.8–6.8), -0.5±0.5 (-4.5–1.5), and -0.3±1.3 (-11.6–6.8), respectively. All preoperative values were statistically insignificant between the groups, while postoperative values were significant with P-values <0.001. Predictability and efficacy index was higher for the FAL (92.1%, 1.00) than the HM group (82.2%, 0.84). Similarly, patient satisfaction was slightly higher for those treated with FAL (93.3%) than HM (91.4%).Conclusion: Our large retrospective analysis of eyes that have undergone LASIK using HM and FAL shows superior refractive outcomes in the latter, with special regard to procedural efficacy and predictability. Keywords: laser-assisted in situ keratomileusis, femtosecond, microkeratome, cornea, refractive surgery