Transepithelial Laser versus Alcohol Assisted Photorefractive Keratectomy Safety and Efficacy: 1-Year Follow-up of a Contralateral Eye Study

Published on Feb 18, 2021in Korean Journal of Ophthalmology
· DOI :10.3341/KJO.2020.0105
Hesham Mohamed Gharieb2
Estimated H-index: 2
(Ain Shams University),
Mo'mena Ahmad A Awad-Allah (Ain Shams University)+ 1 AuthorsIhab Saad Othman4
Estimated H-index: 4
(Cairo University)
Purpose to compare single-step transepithelial PRK (TPRK) to conventional alcohol assisted epithelial removal then PRK (AAPRK) regarding pain, epithelial healing, visual acuity, corneal haze measured subjectively and objectively, higher order aberrations changes, contrast sensitivity and vector analysis of astigmatic correction with one year follow-up. Patients and methods a prospective double-blind randomized study of 29 subjects (58 eyes) who underwent myopic aberration-free laser correction by Smart Pulse Technology using Schwind Amaris 1050Hz (SCHWIND eye-tech-solutions GmbH, Kleinostheim, Germany) with one year follow-up. Right eye was randomly treated by AAPRK or TPRK. Postoperative assessment was performed on day 1 and 3, at 1st week, and 1st, 3rd, 6th and 12th months. Patients were assessed for pain, epithelial healing, visual acuity, corneal haze, astigmatic correction, higher order aberrations and contrast sensitivity. Results Epithelial healing was complete by the third day in 62.1% of AAPRK eyes and in 89.7% of TPRK eyes. First day postoperative pain was higher in TPRK group (P= 0.0134). The Decimal uncorrected visual acuity at 12 months was 1.47±0.39 and 1.57±0.38 in the AAPRK and TPRK groups respectively (P= 0.3719). Post-PRK haze reached a final level of 0.04±0.14 and 0.02±0.1 in AAPRK and TPRK groups respectively (P= 0.5607). Contrast sensitivity was comparable in low and high frequency cycles per degree. Vector analysis of astigmatic correction showed correction index at one year of 0.99 and 1.05 for AAPRK and TPRK groups respectively. Conclusion Alcohol assisted and transepithelial PRK have comparable results regarding safety and efficacy.
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