| Purpose : To evaluate initial clinical outcome with Epi-LASIK and Femtosecond LASIK in high myopia with thin cornea Method : Six months results from a cohort A of 22 eyes ( 15 patients with high myopia with thin cornea ) that had Epi-LASIK procedures were studied .On the other hand , three months results form a cohort B of 74 eyes (35 patients with high myopia with thin cornea ) that had Femtosecond LASIK procedures were also studied with .All Epi-LASIK operations were done with Amadeus 2 and Femtosecond LASIK were done with Intralase ( AMO, Santa Ana ,CA , USA ). For EPi-LASIK , epithelial separation was achieved mechanically without the use of alcohol. The epithelial flap was removed and a therapeutic contact lens was applied to the cornea immediately for 3 to 5 days. For Femtosecond LASIK ( Intra-LASIK) , lamellar flap was created with femtosecond laser. All patients went customized laser treatment. Postoperative symptoms, UCVA as well as BCVA were evaluated at three months postoperatively. Result : The average of diopters for Epi-LASIK patients were 8.5+0.3 D myopia with cornea thickness 485+12 mm , where as Intra-LASIK patients were 10.2+0.6 D with cornea thickness 510+15 mm. During first 4 to 5 days with Epi-LASIK patients, mild pain discomforts were complained in 16 eyes (72%), moderate pain were in 4 eyes (18%) and severe pain were in 2 eyes (11%).However, for the Intra-LASIK, mild pain discomforts were complained in 4 eyes (6%) during first 3 days. On other hand, during first month, mild dry eye discomforts were complained in 12 eyes (55%) with Epi-LASIK, 25 eyes (35%) with Intra-LASIK. At three months, cohort A group with Epi-LASIK, 95% had an UCVA of 20/25, and no eye lost any lines of BCVA, whereas 4 of 22 eyes gained one or two lines of BCVA. Regarding to Cohort B group with Intra-LASIK, 98% had an UCVA of 20/25, and no eye lost any lines of BCVA, whereas 10 of 74 eyes gained one or two lines of BCVA Discussion: Epi-LASIK as a surface ablation and Intralase femtosecond laser as a lamellar ablation are both safe and efficient methods to correct patients in high myopia with thin cornea with the efforts to have mild symptoms (pain and dryness), better UCVA as well as BCVA in our early clinical outcome. However, how to choose candidates for both operation and longer follow up as well as larger study are recommended to evaluate its long term impact. |
