Photorefractive Keratectomy: Transepithelial Versus Conventional

De Souza, Luiza

Photorefractive Keratectomy: Transepithelial Versus Conventional

Friday, April 17, 2015

KIOSKS (San Diego Convention Center)

Luiza A. De Souza, MD

Marcos A. Garcia, MD

Celso A. Goncalves, MD

Gabriel A. Jacob, MD

Pedro M. Morais, MD

Romano R. De Vasconcelos, MD

Purpose
Transepithelial photorefractive keratectomy (PRK), also known as all laser procedure, emerges as an alternative to PRK with mechanical manipulation of the epithelium. This study between the two techniques, with the Amaris schwind platform, look for compair the results in short term evaluation for moderate myopic patients.

Methods
20 patients underwent PRK all laser procedure with Amaris Schwind 750 Hz and 20 patients with mechanical removal at the epithelium with Amoils brush,ranging from age 18 to 60 years old,corneal central thickness superior to 500 µm, ablation until 100 µm,for myopic patients.The Amaris PTK ablation target is 55 µm centrally and 65 µm at the periphery of the 8-mm ablation zone.All patients received Mitomycin–C 0,02% for 40 seconds,a soft bandage contact lens,topical gatiofloxacin,prednisolone 0,2% topical and topical carboxymetilcelulose 0,5%.Pos operative pain was assessed by patient report and epithelial healing was evaluated by daily, until the re-epithelialization was complete.

Results
Patients in group of Transepithelial PRK showed that pain was higher on the first postoperative day compared with those in group of Conventional PRK ( P = 0,008) and and this difference was statistically significant. However, on the second postoperative day, mean pain scores were similar. Mean time to epithelial healing was longer after Conventional PRK, 70 % of patients had complete healing at 3 days postoperatively. And after transepithelial PRK , 65% of patients had complete epithelial healing by 2 days. This difference was statistically significant (P= 0,027). Refractive results were excellent and highly predictable in both techniques.

Conclusion
This study, showed that transepithelial PRK using Amaris Schwind plataform and conventional PRK demonstrates comparable refractive outcomes. The transepithelial PRK is effective, safe and predictable, faster epithelial healing and higher pain on the immediate pos operative than conventional PRK.