AIM: To compare the safety, efficacy, predictability, stability and complications of wavefront-guided laser-assisted subepithelial keratectomy(LASEK)in low myopia, myopic astigmatism and high myopia correction.

METHODS: A retrospective analysis of 416 eyes were assigned to 3 groups: 159 eyes with low myopia(LM)and mean refractive spherical equivalent(MRSE)of -3.68±1.33 dioptre(D); 161 eyes with myopic astigmatism(MA)and MRSE of -5.99±2.24D and mean cylinder of 2.41±1.07D; and 96 eyes with high myopia(HM)and MRSE of -7.41±0.80D. After an epithelial flap creation, a wavefront-based excimer laser ablation was performed. Safety, efficacy, predictability and stability were evaluated at day 10, 2, 6 and 12mo postoperatively.

RESULTS:At 12mo, the MRSE was -0.36±0.31D in LM group, 0.15±0.41D in MA group and 0.58±0.68D in HM group. The uncorrected visual acuity(UCVA)was 20/20 in 90.60% of patients in LM group, 78.90% in MA group and 67% in HM group. Efficacy indices were 0.98, 1.04 and 0.92 in LM, MA and HM groups, respectively. Safety indices were 1.00, 1.07 and 1.05 in LM, MA and HM respectively. Five eyes(3.1%)in the LM group gained 1 line. Forty-four eyes(27.3%)in MA gained 1-3 lines and eighteen eyes(19.2%)of HM group gained 1-2 lines of BSCVA. Only 2 eyes in LM group developed corneal haze. There were not statistically significant differences in efficacy and safety indices amongst three groups.

CONCLUSION: Wavefront-guided LASEK is an effective and safe procedure for the treatment of LM, MA, and HM.although in myopic astigmatism the predictability, efficacy and safety indices had been better.