This systematic review was to compare the clinical outcomes between laser-assisted subepithelial keratectomy (LASEK) and laser\nin situ keratomileusis (LASIK) for myopia. Primary parameters included mean manifest refraction spherical equivalent (MRSE),\nMRSE within �±0.50 diopters, uncorrected visual acuity (UCVA) ?20/20, and loss of ?1 line of best-corrected visual acuity (BCVA).\nSecondary parameters included flap complications and corneal haze. Twelve clinical controlled trials were identified and used for\ncomparing LASEK (780 eyes) to LASIK (915 eyes). There were no significant differences in visual and refractive outcomes between\nthe two surgeries for low to moderate myopia. The incidence of loss of ?1 line of BCVA was significantly higher in moderate to\nhigh myopia treated by LASEK than LASIK in the mid-term and long-term followup. The efficacy (MRSE and UCVA) of LASEK\nappeared to be a significant worsening trend in the long-term followup. Corneal haze was more severe in moderate to high myopia\ntreated by LASEK than LASIK in the mid-term and long-term followup. The flap-related complications still occurred in LASIK,\nbut the incidence was not significantly higher than that in LASEK. LASEK and LASIK were safe and effective for low to moderate\nmyopia. The advantage of LASEK was the absence of flap-related complications, and such procedure complication may occur in\nLASIK and affect the visual results. The increased incidence of stromal haze and regression in LASEK significantly affected the\nvisual and refractive results for high myopia.
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