Previous studies have produced inconsistent conclusions on the relative benefits between LASEK vs. Epi-LASIK. LASEK uses 20% alcohol to separate an epithelial flap from the Bowman membrane. After ablation, the epithelial flap is repositioned onto the cornea. Epi-LASIK creates the epithelial flap using a microkeratome-like instrument, the epikeratome. Theoretically, as it preserves the basement membrane and avoids the use of chemical agents, it offers faster epithelium healing and less postoperative pain than LASEK. This meta-analysis consisting of three randomised control trials (RCTs) and three non-randomised cohort studies compared differences in safety, efficacy, predictability, epithelial healing time and corneal haze formation between LASEK and Epi-LASIK. The meta-analysis included 517 eyes from six studies with myopia ranging from 0 to -9.00D. No significant differences were found in the proportion of eyes with uncorrected visual acuity (VA) of 6/6 or better, mean postoperative uncorrected VA, healing time of corneal epithelium, final proportion of eyes losing two or more lines of best spectacle corrected VA and corneal haze levels. The authors concluded that although this meta-analysis demonstrated similar safety and efficacy between LASEK and Epi-LASIK, more data is required to detect the potential differences between the two procedures.

Laser-assisted sub epithelial keratectomy versus epipolis laser in situ keratomileusis for myopia: a meta-analysis of clinical outcomes.
Wen D, Huang J, Li X, et al.
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Anjali Gupta

Birmingham and Midland Eye Centre, Birmingham, UK.

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