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Laser-epitheliale Keratomileusis (LASEK) zur Behandlung von Myopien bis -6,0 dpt

Ergebnisse nach 12 Monaten bei 108 Augen

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Zusammenfassung

Hintergrund

Die Laser-epitheliale Keratomileusis (LASEK) ist ein relativ neues keratorefraktives Verfahren zur Behandlung von Myopie und myopem Astigmatismus. Es werden die Ergebnisse von 108 konsekutiv LASEK-behandelten Augen mit einer Nachbeobachtungszeit von 12 Monaten vorgestellt.

Patienten und Methoden

Bei 108 Augen wurde eine LASEK mit dem Keracor-117-Excimer-Laser durchgeführt. Die mittlere präoperative Myopie betrug −4,12±1,30 dpt sphärisches Äquivalent (SÄ), der Astigmatismus maximal 3,25 dpt. Die 12-Monatsergebnisse liegen für 101 Augen (93,5%) vor.

Ergebnisse

Es traten keine schwerwiegenden Komplikationen auf. Nach 12 Monaten lagen 96% der Augen innerhalb von ±1,0 dpt und 86% innerhalb von ±0,5 dpt SÄ um Emmetropie. Ein Verlust an korrigiertem Visus von mehr als 1 Zeile oder ein kornealer Haze von mehr als Grad 1 wurde bei keinem Auge festgestellt. Ein unkorrigierter Visus (UCVA) von ≥1,0 wurde von 80%, von ≥0,5 von 98% der Augen erzielt.

Schlussfolgerungen

Mit der LASEK scheinen Myopien und myope Astigmatismen bis −6 dpt sicher und effektiv korrigiert werden zu können. Die Ergebnisse nach LASEK sind nach den bisherigen Erfahrungen mit denen nach PRK und LASIK vergleichbar. Die Ausbildung von Haze nach LASEK scheint gering. Die Abdeckung der stromalen Wunde mit einem vitalen Epithelläppchen könnte die postoperativen Wundheilungsreaktionen günstig beeinflussen.

Abstract

Background

Laser epithelial keratomileusis (LASEK) is a new keratorefractive procedure for the correction of myopia and myopic astigmatism, which may combine advantages and eliminate disadvantages of photorefractive keratectomy (e.g. pain, corneal haze) and laser in situ keratomileusis (e.g. flap and interface complications, dry eye, keratectasia). We present the results of 108 consecutively LASEK-treated eyes with a follow-up period of 12 months.

Patients and methods

LASEK was performed on 108 consecutive eyes with myopia or myopic astigmatism using a keracor 117 excimer laser. The mean preoperative refraction was −4.12±1.30 diopters (D) spherical equivalent range: −1.75 to −6.0 D and maximal cylinder was 3.25 D. Results of the 12 months visit are available for 101 eyes (93.5%).

Results

No serious complications were observed. After 12 months, SE was within ±1.0 D of emmetropia in 96% and within ±0.5 D in 86% of the eyes; 6 eyes had to be retreated. None of the eyes showed haze worse than grade 1 or lost more than one line of best-corrected visual acuity. Uncorrected visual acuity (UCVA) was ≥20/20 in 80% and ≥20/40 in 98%.

Conclusions

Laser epithelial keratomileusis (LASEK) seems to be safe and effective in treatment of myopia and myopic astigmatism of up to −6.0 D. Preliminary results compare favourably with those after photorefractive keratectomy and laser in situ keratomileusis. Haze formation after LASEK seems to be low. Coverage of the stromal wound with a vital epithelial flap could positively influence postoperative wound healing reactions.

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Authors and Affiliations

  1. Augenklinik der Universität Regensburg, Regensburg

    B. Gabler, C. Winkler von Mohrenfels, W. Herrmann & C. P. Lohmann

  2. Augenklinik der Universität Regensburg, Franz-Josef-Strauss-Allee, 93042 , Regensburg

    B. Gabler

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  1. B. Gabler
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  2. C. Winkler von Mohrenfels
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  3. W. Herrmann
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  4. C. P. Lohmann
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Correspondence to B. Gabler.

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Gabler, B., von Mohrenfels, C.W., Herrmann, W. et al. Laser-epitheliale Keratomileusis (LASEK) zur Behandlung von Myopien bis -6,0 dpt. Ophthalmologe 101, 146–152 (2004). https://doi.org/10.1007/s00347-003-0885-0

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