Comparison of postoperative pain following laser-assisted subepithelial keratectomy and transepithelial photorefractive keratectomy: a prospective, random paired bilateral eye study.

PURPOSE: To compare postoperative pain following laser-assisted subepithelial keratectomy (LASEK) and transepithelial photorefractive keratectomy (T-PRK, two-step surgery) and alleviate postoperative subjective pain.

METHODS

Thirty patients (60 eyes) with myopia or myopic astigmatism were consecutively recruited into this prospective, randomized paired study. Patients underwent LASEK in one eye, and T-PRK in the other. The degree of pain was rated on a scale of 0-10 on postoperative days 1, 2 and 3. Uncorrected visual acuity (UCVA) and subepithelial corneal haze were assessed at postoperative 1 and 3 months.

RESULTS

The pain was relieved on the 4th postoperative day in all patients, healing of corneal epithelium was observed at 4-5 days after surgery and contact lenses were removed promptly. At postoperative 1 day, the mean subjective pain score in the LASEK group was 3.2 ± 1.88 and 4.43 ± 1.61 in T-PRK group (P = 0.008). No significant difference was found between two groups on postoperative 2 and 3 days. At postoperative 3 months, the percentage of UCVA ≥ 0.8 in the LASEK group was 100% and 96.7% in the T-PRK group (P = 0.24), 93.3% of patients in the LASEK with UCVA ≥ 1.0 and 90% in the T-PRK group (P = 0.64). In the LASEK group, the value of corneal haze was 0.26 ± 0.21 and 0.27 ± 0.25 in the T-PRK group (P = 0.877).

CONCLUSION

Good visual acuity was obtained in both groups at postoperative 3 months. Compared with those in the T-PRK group, patients undergoing had less discomfort in the LASEK group, which may be associated with corneal epithelial activity. The changing curve of subjective pain in the T-PRK group was relatively flat and stable at postoperative 3 days.