Single-Step Transepithelial PRK and PRK With Alcohol-Mediated Epithelial Removal: Comparative Study
To evaluate the visual and refractive outcomes of single-step transepithelial PRK and alcohol-assisted PRK over one year period.
Retrospective review of the charts of 254 eyes with transepithelial PRK and 184 eyes with alcohol-mediated PRK all performed at the American University of Beirut Medical Center by the same surgeon using the same laser platform (Schwind Amaris). Patients were contacted to evaluate the symptoms of subclinical recurrent erosions postoperatively via a questionnaire.
Preoperatively, the mean manifest refractive spherical equivalence (MRSE) was -4.73+/-1.74 D and -4.42+/-2.63 D for the transepithelial PRK and alcohol PRK, respectively (P=0.15). Postoperatively, at 1,3,6, and 12 months, mean MRSE were +0.20+/-0.75 vs +0.12+/-0.87 ,+0.05+/-0.49 vs +0.25+/-0.67, +0.01+/-0.43 vs +0.03+/-0.59, and -0.02+/-0.22 vs -0.07+/-0.49 (P=0.15), for the transepithelial PRK and alcohol PRK, respectively. The average corneal haze was similar in both groups. 1.4% of single-step transepithelial PRK patients noted sharp ocular pain and 2.8 % experienced “eyelid sticking to the eyeballs”, all in the early morning, as opposed to 15.7% (P=0.004) and 10% (P=0.165), respectively for patients with alcohol-assisted PRK.
Single-step transepithelial PRK is safe and effective, with patients being less susceptible to subclinical recurrent erosions than alcohol-mediated PRK.