Transepithelial photorefractive keratectomy: clinical results

J Cataract Refract Surg. 2011 Oct;37(10):1852-7. doi: 10.1016/j.jcrs.2011.04.029. Epub 2011 Aug 15.

Abstract

Purpose: To assess the effectiveness, safety, and comfort of transepithelial photorefractive keratectomy (PRK) using the Amaris laser platform.

Setting: Ophthalmic Consultants of Beirut, Jal-El-Dib, Metn, Lebanon.

Design: Comparative case series.

Methods: Myopic eyes with or without astigmatism were treated by transepithelial PRK (study group) and compared with variable-adjusted eyes treated by conventional PRK (control group) during which the epithelium was removed with alcohol. Postoperative pain, epithelial healing time, uncorrected distance visual acuity (UDVA), manifest refraction, and haze were analyzed.

Results: The mean subjective postoperative pain score (out of 10, indicating worst pain) at 48 hours was 2.0 in the study group (50 eyes) and 4.5 in the control group (50 eyes) (P=.02). The mean time to complete epithelial healing was 2.5 days ± 0.6 (SD) and 3.7 ± 0.8 days, respectively (P=.01). At 1 week, the UDVA was statistically significantly better in the control group; however, at 3 months, there was no statistically significant difference in UDVA, corrected distance visual acuity, or manifest refraction between the groups. Haze was significantly less in the study group (P<.01).

Conclusions: Transepithelial PRK for mild to moderate myopia with or without astigmatism was safe and easier to perform than conventional PRK, and patients had less pain, less postoperative haze, and a faster healing time. The visual outcomes with the 2 techniques were comparable.

Financial disclosure: No author has a financial or proprietary interest in any material or method mentioned.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Astigmatism / physiopathology
  • Astigmatism / surgery*
  • Debridement
  • Epithelium, Corneal / surgery*
  • Eye Pain / physiopathology
  • Female
  • Humans
  • Lasers, Excimer / therapeutic use*
  • Male
  • Middle Aged
  • Myopia / physiopathology
  • Myopia / surgery*
  • Pain Measurement
  • Photorefractive Keratectomy / methods*
  • Refraction, Ocular / physiology
  • Treatment Outcome
  • Visual Acuity / physiology
  • Young Adult