Comparison of 3 Epithelial Removal Techniques in Photorefractive Keratectomy: Mechanical, Alcohol-Assisted, and Transepithelial Laser

Tuesday, April 21, 2015: 1:46 PM
Room 1B (San Diego Convention Center)
Shmuel Levartovsky, MD
Tzahi Sela
Gur Munzer
Igor Kaiserman, MD MSC

To compare visual and refractive results following Photorefractive Keratectomy (PRK) using three different epithelial removal techniques

The medical files of consecutive eyes with myopia and myopic astigmatism that underwent mechanical PRK, alcohol-assisted PRK or transepithelial (t)PRK between May 2000 and December 2013 were reviewed

Overall, 14,489 eyes were included. tPRK technique resulted in a significantly better Efficacy Index (p<0.01) and Safety Index (p<0.0001) up to 1 month postoperative, while alcohol-assisted PRK was superior both in Efficacy Index (p<0.01) and Safety Index (p<0.05) at  >3 months postoperative. At long-term follow up ( >1 year), tPRK exhibited inferiority in terms of visual Efficacy Index outcome that corresponded to a mean uncorrected visual acuity of approximately 1 Snellen line lower than the other groups (p<0.0001). While all three techniques exhibited a clinically acceptable Safety Index, at all times mechanical PRK technique was significantly inferior to the other groups (p<0.01).

Significant differences were detected in the visual outcomes as well as in the refractive results of these three epithelial removal techniques. Although the short term follow up results tPRK showed superiority, at the long term follow up alcohol-assisted PRK showed significantly better Safety Index and Efficacy Index results