Comparing Visual Outcomes of KLEx, PRK, and LASIK Procedures in the Military Population

Charisma B Evangelista; Justin P Harris; Toan M Trinh; Paul D Kohler; Ryan Mackie; Sergei Turovets; James K Aden; Jose E Capo-Aponte

doi:10.1097/j.jcrs.0000000000001565

Comparing Visual Outcomes of KLEx, PRK, and LASIK Procedures in the Military Population

J Cataract Refract Surg. 2024 Oct 9. doi: 10.1097/j.jcrs.0000000000001565. Online ahead of print.

Authors

Charisma B Evangelista^{1

2}, Justin P Harris^{1

2}, Toan M Trinh³, Paul D Kohler¹, Ryan Mackie³, Sergei Turovets³, James K Aden⁴, Jose E Capo-Aponte¹

Affiliations

¹ Joint Warfighter Refractive Surgery Center, Wilford Hall Ambulatory Surgical Center, Joint Base San Antonio-Lackland, TX.
² Department of Ophthalmology, Brooke Army Medical Center, Joint Base San Antonio, TX.
³ United States Army Aeromedical Research Laboratory, Fort Novosel, AL.
⁴ Department of Graduate Medical Education, Brooke Army Medical Center, Joint Base San Antonio, TX.

PMID: 39380189
DOI: 10.1097/j.jcrs.0000000000001565

Abstract

Purpose: To assess the 6-month visual and refractive outcomes of keratorefractive lenticule extraction (KLEx) as compared to laser in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK) in a military population at a Joint Warfighter Refractive Surgery Center.

Setting: Joint Warfighter Refractive Surgery Center (JWRSC), Lackland Air Force Base, San Antonio, TX.

Design: Retrospective Study.

Methods: Patients who underwent either KLEx, PRK, or LASIK between 2019-2022 were included. Anonymized data collected included demographics, pre- and post-operative uncorrected and corrected visual acuity, and manifest refraction.

Results: Of the 4,466 treated eyes, 737 (16.5%) underwent the KLEx, 2,801 (62.7%) underwent PRK, and 928 (20.8%) underwent LASIK treatment. In terms of efficacy, there was no statistically significant difference at post-operative month (POM)6 between the percentage of eyes reaching an uncorrected distance visual acuity (UDVA) of 20/20 or better between the three procedures. At POM1 (P < 0.001) and POM3 (P < 0.001), there were a greater number of eyes in the KLEx group that achieved the same or 1 line better of distance visual acuity than the PRK group. The efficacy index of KLEx, PRK, and LASIK at POM6 were 1.09, 1.10, and 0.97, respectively. The safety index for KLEx, PRK, and LASIK at POM6 were 0.96, 1.01, and 0.81, respectively.

Conclusions: After the initial recovery period, KLEx demonstrates comparable outcomes in terms of efficacy, safety, and accuracy as compared to LASIK and PRK.