Efficacy and Safety Profile of Laser-Assisted In-Situ Keratomileusis and Photorefractive Keratectomy for Myopia Correction: A Systematic Review and Meta-Analysis

Authors

  • Irfan Bari Cahyoputra Universitas Sebelas Maret, Surakarta (Indonesia)
  • Aqila Fathimah Putri Universitas Tarumanagara, Jakarta (Indonesia) https://orcid.org/0009-0003-0897-7393

DOI:

https://doi.org/10.31288/Ukr.j.ophthalmol.202625765

Keywords:

LASIK, Meta-analysis, Myopia, Photorefractive Keratectomy

Abstract

Introduction. Myopia is one of the important causes of visual impairment worldwide. The two most common refractive surgeries for myopia treatment are LASIK (Laser-Assisted In-Situ Keratomileusis) and PRK (Photorefractive Keratectomy).
Purpose. This study investigates the efficacy and safety of LASIK and PRK for Myopia correction.
Methods. A systematic review was conducted following PRISMA 2020 guidelines across PubMed, Cochrane, and ScienceDirect databases through December 2024. The quality and bias of studies were assessed using the assessment tool developed by the Effective Public Health Practice Project. The data were summarized using odds ratios (OR) with 95% confidence intervals (CI) and mean differences to determine the efficacy and safety of LASIK and PRK for myopia.
Result. Nine randomized controlled trial studies from 1998 to 2014 were included, involving 698 eyes with any degree of myopia. The meta-analysis found no significant difference in the proportion of eyes achieving uncorrected visual acuity of 20/20 at 6 months (pooled OR, 0.84; 95% CI, 0.53-1.34; P = 0.47) and 12 months (pooled OR, 1.11; 95% CI, 0.62-2.01; P = 0.72). LASIK and PRK were equally effective for the proportion of eyes achieving within ± 0.50 D of target refraction at 12 months (OR, 1.00; 95% CI, 0.40–2.51; P = 1.00). Loss of 2 lines of best corrected visual acuity at 6 months was less frequent with LASIK (OR, 2.41; 95% CI, 0.73-7.18; P = 0.15). It was found that both LASIK and PRK interventions did not have a significant difference in postoperative mean spherical equivalent until 1 year of follow-up (0.07; 95% CI, 0.05-0.19; I2 = 16%).
Conclusions. Efficacy, safety and visual outcomes of LASIK for myopia are similar to those achieved with PRK.

References

Holden BA, Fricke TR, Wilson DA, Jong M, Naidoo KS, Sankaridurg P, et al. Global Prevalence of Myopia and High Myopia and Temporal Trends from 2000 through 2050. Ophthalmology. 2016 May;123(5):1036-42. https://doi.org/10.1016/j.ophtha.2016.01.006

Gurnani B, Kaur K. Recent Advances in Refractive Surgery: An Overview. Clin Ophthalmol. 2024 Sep 2;18:2467-2472. doi: 10.2147/OPTH.S481421.https://doi.org/10.2147/OPTH.S481421

Li SM, Zhan S, Li SY, Peng XX, Hu J, Law HA, Wang NL. Laser-assisted subepithelial keratectomy (LASEK) versus photorefractive keratectomy (PRK) for correction of myopia. Cochrane Database Syst Rev. 2016 Feb 22;2(2):CD009799.https://doi.org/10.1002/14651858.CD009799.pub2

Chang JY, Lin PY, Hsu CC, Liu CJ. Comparison of clinical outcomes of LASIK, Trans-PRK, and SMILE for correction of myopia. J Chin Med Assoc. 2022 Feb 1;85(2):145-151. https://doi.org/10.1097/JCMA.0000000000000674

Gao H, Miles TP, Troche R, Murdoch DM, Koefoed VF, Cason JB. Quality of Vision Following LASIK and PRK-MMC for Treatment of Myopia. Mil Med. 2022 Aug 25;187(9-10):e1051-e1058. https://doi.org/10.1093/milmed/usab071

Gershoni A, Reitblat O, Mimouni M, Livny E, Nahum Y, Bahar I. Femtosecond laser assisted in situ keratomileusis (FS-LASIK) yields better results than transepithelial photorefractive keratectomy (Trans-PRK) for correction of low to moderate grade myopia. Eur J Ophthalmol. 2021 Nov;31(6):2914-2922. https://doi.org/10.1177/1120672120980346

Chang YM, Liang CM, Weng TH, Chien KH, Lee CH. Mitomycin C for the prevention of corneal haze in photorefractive keratectomy: a meta-analysis and trial sequential analysis. Acta Ophthalmol. 2021 Sep;99(6):652-662. https://doi.org/10.1111/aos.14704

Chang JY, Lin PY, Hsu CC, Liu CJ. Comparison of clinical outcomes of LASIK, Trans-PRK, and SMILE for correction of myopia. J Chin Med Assoc. 2022 Feb 1;85(2):145-151. https://doi.org/10.1097/JCMA.0000000000000674

Castro-Luna G, Jiménez-Rodríguez D, Pérez-Rueda A, Alaskar-Alani H. Long Term Follow-Up Safety and Effectiveness of Myopia Refractive Surgery. Int J Environ Res Public Health. 2020 Nov 24;17(23):8729. https://doi.org/10.3390/ijerph17238729

El-Maghraby A, Salah T, Waring GO 3rd, Klyce S, Ibrahim O. Randomized bilateral comparison of excimer laser in situ keratomileusis and photorefractive keratectomy for 2.50 to 8.00 diopters of myopia. Ophthalmology. 1999 Mar;106(3):447-57.https://doi.org/10.1016/S0161-6420(99)90102-1

Manche EE, Haw WW. Wavefront-guided laser in situ keratomileusis (Lasik) versus wavefront-guided photorefractive keratectomy (Prk): a prospective randomized eye-to-eye comparison (an American Ophthalmological Society thesis). Trans Am Ophthalmol Soc. 2011 Dec;109:201-20.

Lee JB, Kim JS, Choe C, Seong GJ, Kim EK. Comparison of two procedures: photorefractive keratectomy versus laser in situ keratomileusis for low to moderate myopia. Jpn J Ophthalmol. 2001 Sep-Oct;45(5):487-91.https://doi.org/10.1016/S0021-5155(01)00406-3

Hersh PS, Brint SF, Maloney RK, Durrie DS, Gordon M, Michelson MA,et al. Photorefractive keratectomy versus laser in situ keratomileusis for moderate to high myopia. A randomized prospective study. Ophthalmology. 1998 Aug;105(8):1512-22, discussion 1522-3.https://doi.org/10.1016/S0161-6420(98)98038-1

Hersh PS, Steinert Roger F, Brint SF, Summit PRK-LASIK Study Group. Photorefractive keratectomy versus laser in situ keratomileusis. Comparison of optical side effects. Ophthalmology. 2000 May; 107(5): 925-933 https://doi.org/10.1016/S0161-6420(00)00059-2

Wallau AD, Campos M. One-year outcomes of a bilateral randomised prospective clinical trial comparing PRK with mitomycin C and LASIK. Br J Ophthalmol. 2009 Dec;93(12):1634-8. https://doi.org/10.1136/bjo.2008.152579

Hatch BB, Moshirfar M, Ollerton AJ, Sikder S, Mifflin MD. A prospective, contralateral comparison of photorefractive keratectomy (PRK) versus thin-flap LASIK: assessment of visual function. Clin Ophthalmol. 2011;5:451-7. https://doi.org/10.2147/OPTH.S18967

Barreto J Jr, Barboni MT, Feitosa-Santana C, Sato JR, Bechara SJ, Ventura DF, Alves MR. Intraocular straylight and contrast sensitivity after contralateral wavefront-guided LASIK and wavefront-guided PRK for myopia. J Refract Surg. 2010 Aug;26(8):588-93. https://doi.org/10.3928/1081597X-20090930-01

Arora R, Goel Y, Goyal JL, Goyal G, Garg A, Jain P. Refractive outcome of wavefront guided laser in situ keratomileusis and wavefront guided photorefractive keratectomy in high pre-existing higher order aberration. Cont Lens Anterior Eye. 2015 Apr;38(2):127-33.https://doi.org/10.1016/j.clae.2014.12.001

Li SM, Kang MT, Wang NL, Abariga SA. Wavefront excimer laser refractive surgery for adults with refractive errors. Cochrane Database Syst Rev. 2020 Dec 18;12(12):CD012687. https://doi.org/10.1002/14651858.CD012687.pub2

Tomás-Juan J, Murueta-Goyena Larrañaga A, Hanneken L. Corneal Regeneration After Photorefractive Keratectomy: A Review. J Optom. 2015 Jul-Sep;8(3):149-69. https://doi.org/10.1016/j.optom.2014.09.001

Mounir A, Mostafa EM, Ammar H, Mohammed OA, Alsmman AH, Farouk MM, Elghobaier MG. Clinical outcomes of transepithelial photorefractive keratectomy versus femtosecond laser assisted keratomileusis for correction of high myopia in South Egyptian population. Int J Ophthalmol. 2020 Jan 18;13(1):129-134. https://doi.org/10.18240/ijo.2020.01.19

Aslanides IM, Padroni S, Arba Mosquera S, Ioannides A, Mukherjee A. Comparison of single-step reverse transepithelial all-surface laser ablation (ASLA) to alcohol-assisted photorefractive keratectomy. Clin Ophthalmol. 2012;6:973-80. https://doi.org/10.2147/OPTH.S32374

Chaurasia SS, Kaur H, de Medeiros FW, Smith SD, Wilson SE. Dynamics of the expression of intermediate filaments vimentin and desmin during myofibroblast differentiation after corneal injury. Exp Eye Res. 2009 Aug;89(2):133-9. doi: 10.1016/j.exer.2009.02.022. Epub 2009 Mar 11.https://doi.org/10.1016/j.exer.2009.02.022

Hofmeister EM, Bishop FM, Kaupp SE, Schallhorn SC. Randomized dose-response analysis of mitomycin-C to prevent haze after photorefractive keratectomy for high myopia. J Cataract Refract Surg. 2013 Sep;39(9):1358-65.https://doi.org/10.1016/j.jcrs.2013.03.029

Ouerdane Y, Zaazouee MS, Mohamed MEA, Hasan MT, Hamdy M, Ghoneim AM, et al. Mitomycin C application after photorefractive keratectomy in high, moderate, or low myopia: Systematic review and meta-analysis. Indian J Ophthalmol. 2021 Dec;69(12):3421-3431.https://doi.org/10.4103/ijo.IJO_3768_20

Tahzib NG, Bootsma SJ, Eggink FA, Nabar VA, Nuijts RM. Functional outcomes and patient satisfaction after laser in situ keratomileusis for correction of myopia. J Cataract Refract Surg. 2005 Oct;31(10):1943-51. https://doi.org/10.1016/j.jcrs.2005.08.022

Liu YL, Tseng CC, Lin CP. Visual performance after excimer laser photorefractive keratectomy for high myopia. Taiwan J Ophthalmol. 2017 Apr-Jun;7(2):82-88.https://doi.org/10.4103/tjo.tjo_6_17

Van Gelder RN, Steger-May K, Yang SH, Rattanatam T, Pepose JS. Comparison of photorefractive keratectomy, astigmatic PRK, laser in situ keratomileusis, and astigmatic LASIK in the treatment of myopia. J Cataract Refract Surg. 2002 Mar;28(3):462-76.https://doi.org/10.1016/S0886-3350(01)01177-4

Zhang J, Feng Q, Ding W, Peng Y, Long K. Comparison of clinical results between trans-PRK and femtosecond LASIK for correction of high myopia. BMC Ophthalmol. 2020 Jun 19;20(1):243. https://doi.org/10.1186/s12886-020-01515-9

Hashmani N, Hashmani S, Ramesh P, Rajani H, Ahmed J, Kumar J, Kumar A, Jamali M. A Comparison of Visual Outcomes and Patient Satisfaction Between Photorefractive Keratectomy and Femtosecond Laser-Assisted In Situ Keratomileusis. Cureus. 2017 Sep 1;9(9):e1641. https://doi.org/10.7759/cureus.1641

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Published

2026-04-27

How to Cite

[1]
Cahyoputra, I.B. and Putri, A.F. 2026. Efficacy and Safety Profile of Laser-Assisted In-Situ Keratomileusis and Photorefractive Keratectomy for Myopia Correction: A Systematic Review and Meta-Analysis. Ukrainian Journal of Ophthalmology . 2 (Apr. 2026), 57–65. DOI:https://doi.org/10.31288/Ukr.j.ophthalmol.202625765.

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