Comparison of the Short-Term Clinical Results of Epi-LASIK and Photorefractive Keratectomy with Mitomycin-C for Moderate to High Myopia

Purpose: To compare the postoperative results of Epi-LASIK and photorefractive keratectomy-mitomycin (PRK-mitomycin) in patients with moderate to high myopia Methods: For this double-blind clinical trial, samples were randomly selected among those subjects above 20 years of age who were visited for myopia correction and had a spherical equivalent between -4 to -8 D. We randomly performed PRK-mitomycin in one eye and Epi-LASIK in the other eye of the patients. Refraction examinations, visual acuity (VA) measurements, contrast sensitivity testing, and corneal examination were performed at 1, 3, and 6 months after surgery. In the current study, analysis was performed on 3- and 6-month data. Results: Thirty-six eyes were studied. Six months after surgery, the mean spherical equivalent in PRK-mitomycin and Epi-LASIK groups was 0 and -0.1 D, respectively (p=0.994). Six months after surgery, 13 eyes had a spherical equivalent of 0±0.5 D in each group while one diopter of ametropia was seen in 16 and 15 eyes in the PRK-mitomycin and Epi-LASIK groups, respectively. Six months after surgery, one eye in the PRK-mitomycin group and two eyes in the Epi-LASIK group lost 1 line of best corrected visual acuity (BCVA). Six months after surgery, 12 eyes in the PRK-mitomycin group and nine eyes in the Epi-LASIK group had an uncorrected visual acuity (UCVA) of 10/10. The safety index in the PRK-mitomycin and Epi-LASIK group was calculated to be 1.25 and 1.19, respectively (p=0.480). No haze was seen in the PRK-mitomycin group 6 months after surgery while 2 cases in the Epi-LASIK group had haze grade 0.5. There was no significant difference in contrast sensitivity between the two groups (p>0.05). Conclusion: The two methods were similar in postoperative VA and refractive results. Since the chance of haze formation in Epi-LASIK surgery without the application of mitomycin-C (MMC) is similar to PRK with mitomycin, Epi-LASIK can be considered as an alternative to PRK with MMC for the treatment of moderate to high myopia.