Evaluation of the effectiveness of laser in situ keratomileusis and photorefractive keratectomy for myopia : A meta-analysis

Objective: To evaluate the effectiveness of laser in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK) for correcting myopia. Methods : Study selection, data extraction, and quality assessment were performed by two of authors independently. Summary odds ratios and 95% confidence intervals were calculated by DerSimonian amp Laird random-effects model and Mantel-Haenszel (fixed-effects) model. All calculations were based on an intention-to-treat and per protocol analysis. Results : Five hundred and eighty eyes (476 patients) from5 randomized controlled trials were included in this study. At≧6 months follow-up, by random-effects model, the pooled odds ratios (OR, for LASIK vs. PRK) of postoperative uncorrected visual acuity (UCVA) of 20/20 or better for all trials were 1.31 (95% CI=0.77-2.22) by per protocol analysis and 1.18 (95%CI=0.74-1.88) by intention-to-treat analysis. In the refractive outcome, the pooled OR of the postoperative spherical equivalent refraction within±0.5diopter (D) of emmetropia didnot show any statistical significance, for which the OR were 0.75 (95% CI=0.48-1.18) by per protocol analysis and 0.70 (95% CI=0.47-1.04) by intention-to-treat analysis. Conclusions : LASIK and PRK were found to be similarly effective for the correction of myopia from-1.5 to -15.0 D in a greater than 6 month follow-up.