Laser Asymmetric Keratectomy Using a Semi-Cylindrical Ablation Pattern to Avoid Adverse Effects of Laser Refractive Surgery

Purpose: This study aimed to present a novel technique for Laser Epithelial Keratomileusis (LASEK)-Linked Laser Asymmetric Keratectomy using a Semi- Cylindrical Ablation Pattern (L-LAK-SCAP) that can prevent adverse effects following LASEK and simultaneously improve refractive errors and corneal symmetry. Design: This is a single-center retrospective study. Methods: We retrospectively compared the postoperative 1-year clinical results after LASEK only or L-LAK-SCAP for each group of 42 eyes of 21 patients with myopia, with a sum of deviations in the corneal thickness in four directions (SUM) on the Orbscan map of >80multaneously corrected the refractivem. L-LAK-SCAP simultaneously corrected the refractive error (LASEK) and myopic shift by selectively ablating thicker cornea (by LAK), thereby improving corneal symmetry and visual acuity concomitantly. Results: The following measures were similar in both groups (p >0.05): preoperative age, Spherical Equivalent (SE), cylinder, Uncorrected Distance Visual Acuity (UDVA), pupil size, Intraocular Pressure (IOP), and corneal symmetry on Orbscan map. At 1-year postoperatively, the L-LAK-SCAP group showed better results, and the following measures differed significantly between the two groups: SE (p=0.024), UDVA (p=0.001), kappa angle (p=0.030), corneal irregularities in the 3.0mm and 5.0mm zones on the Orbscan map (p=0.033 and 0.034, respectively), SUM (p=0.000), the distance between the maximum posterior elevation (best-fit-sphere) and the visual axis (DISTANCE) (p=0.040), blurring scores (p=0.000), and myopic regression (p=0.004). Conclusion: L-LAK-SCAP improved corneal symmetry, was associated with excellent outcomes, and may prevent adverse events following LASEK.