Femtosecond Vs. Microkeratome-Assisted Lasik In Patients With Low Myopia: A Retrospective Analysis
Published 2025 - 43rd Congress of the ESCRS
Reference: PO696 | Type: Free paper | DOI: 10.82333/2ee1-aj20
Authors: Deepthi R H* 1 , Rohit Shetty 1 , Pooja M Khamar 1 , Raghav Narasimhan 2 , Rahul Patil 2
1Cataract & Refractive Surgery,Narayana Nethralaya,Bangalore,India, 2IBMS,Narayana Nethralaya,Bangalore,India
Purpose
The choice between femtosecond laser-assisted LASIK (FS-LASIK) and microkeratome-assisted LASIK (MK-LASIK) remains a subject of debate, particularly in patients with low myopia, where visual outcomes and complication risks may differ subtly. FS-LASIK offers a more precise flap creation, potentially improving safety and reducing retreatment rates, while MK-LASIK remains widely used due to its cost-effectiveness and efficiency. This study aims to compare these techniques in a large cohort of low myopia patients to determine whether FS-LASIK provides superior outcomes in terms of safety, efficacy, and refractive stability.
Setting
A retrospective analysis of LASIK procedures performed at Care-Vision Laser Centers, a high-volume refractive surgery clinic in Tel Aviv, Israel, between January 2010 and June 2024.
Methods
A retrospective cohort study of 11,277 eyes from patients aged 16–45 years with myopia up to -2.0 diopters who underwent FS-LASIK (n=4,371) or MK-LASIK (n=6,906). Preoperative, intraoperative, and postoperative parameters – including visual acuity, refractive accuracy, safety, efficacy, and retreatment rates – were compared between the groups.
Results
Preoperative characteristics were comparable between groups. FS-LASIK resulted in significantly better postoperative best-corrected visual acuity (1.0010 vs. 0.9957, p=0.0007) and a higher safety index (1.030 vs. 1.025, p=0.0018). Refractive outcomes showed a lower residual spherical error in FS-LASIK (p<0.0001), and astigmatism correction was more precise (p<0.0001). Efficacy remained high in both groups, with FS-LASIK achieving a slightly higher efficacy index (p=0.4986). Retreatment rates were significantly lower with FS-LASIK (0.07% vs. 0.49%, p=0.0035). No cases of postoperative ectasia were reported in either group.
Conclusions
FS-LASIK demonstrated superior safety and precision in low myopia, with better postoperative visual acuity, more accurate astigmatism correction, and a lower need for retreatments compared to MK-LASIK. While both techniques achieved excellent outcomes, FS-LASIK’s enhanced flap precision may provide an additional safety margin. These findings support FS-LASIK as the preferred choice in low myopia when resources allow.