Comparison of LASEK and LASIK With Thin and Ultrathin Flaps After Excimer Laser Ablation With the SCHWIND Aspheric Ablation Profile

PURPOSE: To compare visual, refractive, and wavefront aberration outcomes of laser epithelial keratomileusis (LASEK), thin-flap LASIK (flap thickness 110 to 130 mu m), and ultrathin-flap LASIK (flap thickness <110 mu m) after excimer laser ablation with an aspheric ablation profile. METHODS: A retrospective analysis of 97 eyes of 56 patients with myopia < 6.00 diopters (D) sphere (30 eyes, alcohol-assisted LASEK; 30 eyes, LASIK 110; and 37 eyes, LASIK 130) was conducted. Surgery was performed using the SCHWIND ESIRIS Aberration-Free T aspheric ablation profile and the Carriazo-Pendular microkeratome. RESULTS: Groups were comparable preoperatively except for lower astigmatism and ocular trefoil (3, +3) in the LASIK 130 group and lower corneal thickness in the LASEK group. At 6 months postoperative, the groups were comparable for uncorrected and corrected distance visual acuity, efficacy index, safety, and refractive predictability. All groups demonstrated improved contrast sensitivity. All groups demonstrated a significant change in spherical aberration compared to preoperative levels. The induced spherical aberration was 0.057 mu m/D in the LASEK group, 0.039 mu m/D in the LASIK 110 group, and 0.044 mu m/D in the LASIK 130 group. Other higher order aberrations did not show significant change except for a reduction in corneal trefoil (P = .034) in the LASEK group and increased ocular trefoil (P = .002) in the LASIK 110 group. The extent of change in higher order aberrations was not significantly different among groups. CONCLUSIONS: The aspheric ablation profile is safe, effective, and predictable and produces similar visual and refractive results with three different surgical approaches of LASEK, thin-flap LASIK, and ultrathin-flap LASIK. The ablation profile demonstrated a low induction rate of higher order aberrations regardless of surgical approach. [J Refract Surg. 2011;27(1):38-48.] doi:10.3928/1081597X-20100406-01