Reece C Hall1, Mohamad Rosman1, Cordelia Chan1, Donald T H Tan1, Jodhbir S Mehta2. 1. From the Singapore National Eye Centre (Hall, Rosman, Chan, Tan, Mehta), the Singapore Eye Research Institute (Rosman, Tan, Mehta), the Yong Loo Lin School of Medicine (Tan), National University of Singapore, and the Department of Clinical Sciences (Mehta), Duke-NUS Graduate Medical School, Singapore. 2. From the Singapore National Eye Centre (Hall, Rosman, Chan, Tan, Mehta), the Singapore Eye Research Institute (Rosman, Tan, Mehta), the Yong Loo Lin School of Medicine (Tan), National University of Singapore, and the Department of Clinical Sciences (Mehta), Duke-NUS Graduate Medical School, Singapore. Electronic address: jodmehta@gmail.com.
Abstract
PURPOSE: To describe the subjective experience of patients and surgeons during laser in situ keratomileusis (LASIK) using the Intralase 60 kHz or theVisumax 500 kHz femtosecond laser. SETTING: Singapore National Eye Centre, Singapore. DESIGN: Prospective randomized clinical study. METHODS: In myopic patients, LASIK was performed with the corneal flap created using the 60 kHz laser in 1 eye and the 500 kHz laser in the contralateral eye. Postoperatively, patients completed a standardized validated questionnaire about their subjective intraoperative experiences (eg, light perception, pain, fear). Surgeons reported their intraoperative experiences and preferences. RESULTS:Loss of light perception occurred in 50.0% of 60 kHz laser cases and 0% of 500 kHz laser cases during docking and in 63.0% and 0% of cases, respectively, during laser flap creation (P < .0001). The mean pain score with the 60 kHz laser was significantly higher during docking (P < .0001) but not during laser flap cutting (P = .006). Subconjunctival hemorrhage occurred in 67.4% of eyes with the 60 kHz laser and in 2.2% of eyes with the 500 kHz laser (P < .0001). The 500 kHz laser was preferred by 78.3% of patients, while 21.7% preferred the 60 kHz laser (P < .0001). The surgeons preferred the 60 kHz laser in 50.0% of cases and the 500 kHz laser in 8.7% (P < .0001); 41.3% had no preference. CONCLUSIONS: Patients preferred surgery with the 500 kHz laser with no loss of light perception, less pain, less fear, and less subconjunctival hemorrhage. Surgeons preferred the 60 kHz laser.
RCT Entities:
PURPOSE: To describe the subjective experience of patients and surgeons during laser in situ keratomileusis (LASIK) using the Intralase 60 kHz or the Visumax 500 kHz femtosecond laser. SETTING: Singapore National Eye Centre, Singapore. DESIGN: Prospective randomized clinical study. METHODS: In myopic patients, LASIK was performed with the corneal flap created using the 60 kHz laser in 1 eye and the 500 kHz laser in the contralateral eye. Postoperatively, patients completed a standardized validated questionnaire about their subjective intraoperative experiences (eg, light perception, pain, fear). Surgeons reported their intraoperative experiences and preferences. RESULTS: Loss of light perception occurred in 50.0% of 60 kHz laser cases and 0% of 500 kHz laser cases during docking and in 63.0% and 0% of cases, respectively, during laser flap creation (P < .0001). The mean pain score with the 60 kHz laser was significantly higher during docking (P < .0001) but not during laser flap cutting (P = .006). Subconjunctival hemorrhage occurred in 67.4% of eyes with the 60 kHz laser and in 2.2% of eyes with the 500 kHz laser (P < .0001). The 500 kHz laser was preferred by 78.3% of patients, while 21.7% preferred the 60 kHz laser (P < .0001). The surgeons preferred the 60 kHz laser in 50.0% of cases and the 500 kHz laser in 8.7% (P < .0001); 41.3% had no preference. CONCLUSIONS:Patients preferred surgery with the 500 kHz laser with no loss of light perception, less pain, less fear, and less subconjunctival hemorrhage. Surgeons preferred the 60 kHz laser.