One-year results of butterfly laser epithelial keratomileusis

PURPOSE: To evaluate the risks, complications, and refractive results at 1 year after modified laser epithelial keratomileusis (Butterfly LASEK). METHODS: In a non-randomized prospective study of 773 eyes (452 patients; mean age 34.3 +/- 16.5 years, mean preoperative spherical equivalent refraction -5.30 +/- 3.70 D; mean sphere -4.80 +/- 3.60 D; mean cylinder -1.00 +/- 1.40 D; range -22.50 to +5.50 D), we used a modified LASEK technique and evaluated complications and refractive results at 1 year. The technique is based on the formation of the epithelial flap utilizing alcohol (20% diluted solution applied on the epithelium for 5 to 30 seconds), paracentral abrasion, blunt dissection of the epithelium from the underlying plane; the epithelium is then separated by means of a specially designed retractor. Ablation was performed with a Nidek EC-5000 excimer laser, followed by smoothing and repositioning of the epithelial flap. RESULTS: After 1 year, we analyzed the results of 542 (70.1%) treated eyes with the following outcome: mean postoperative spherical equivalent refraction -0.20 +/- 1.40 D; mean sphere -0.10 +/- 1.30 D; mean cylinder -0.10 +/- 0.60 D; range -2.50 to +0.75 D. In 83.0% of treated eyes, achieved refraction was within +/-0.50 D of planned correction, with uncorrected visual acuity greater than or equal to 1.2 in 19.0% of treated eyes, greater than or equal to 1.0 in 56.0%, and greater than or equal to 0.8 in 19%. Concerning visual acuity, 0.3% of eyes lost 1 line, 49.8% of eyes had no change; 41.8% gained 1 line, 9.8% gained 2 lines, and 1.6% gained more than 2 lines. CONCLUSION: One-year results of this preliminary study showed that Butterfly LASEK was easy to perform, safe, and led to excellent long-term refractive results.