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ORIGINAL ARTICLE
Year : 2020  |  Volume : 33  |  Issue : 4  |  Page : 1171-1177

Transepithelial photorefractive keratectomy for myopic astigmatism in comparison with conventional photorefractive keratectomy


1 Department of Ophthalmology, Faculty of Medicine, Menoufia University, Menoufia, Egypt
2 Department of Ophthalmology, Shebin El-Kom Ophthalmology Hospital, Menoufia, Egypt

Correspondence Address:
Heba S Shetaih
Shebin El-kom, Menoufia 32717
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/mmj.mmj_66_20

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Objectives To compare the outcomes of transepithelial photorefractive keratectomy (Trans-PRK) with those of conventional photorefractive keratectomy (PRK) with respect to the postoperative pain, healing time, visual acuity recovery, and haze. Background PRK was the first of a kind of corrective eye surgery to use a laser rather than a blade to remove corneal tissue. Trans-PRK, where both the epithelium and stroma are removed in a single step, is a relatively new procedure of laser refractive error correction. Patients and methods A prospective comparative nonrandomized study was conducted, where patients with low to moderate myopia with or without astigmatism were assigned to the Trans-PRK group or the PRK group. In the Trans-PRK group, eyes were treated using the Amaris excimer laser. Outcome measures included postoperative pain using a pain questionnaire, epithelial healing time, uncorrected visual acuity, and corneal haze, which were compared between the study groups. Results The mean subjective postoperative pain score (2, indicating hurts little more) at 48 h was 2.26 in Trans-PRK group (97 eyes) and 2.38 in PRK group (97 eyes) (P = 0.369). The mean ± SD time to complete epithelial healing was 2.25 ± 0.6 days and 3.43 ± 0.8 days, respectively (P < 0.001). At 1 week, first month, and third month, the uncorrected visual acuity postoperatively was statistically significantly better in Trans-PRK; however, corrected visual acuity or manifest refraction between the groups was not significant. Haze was significantly less in Trans-PRK group (P = 0.007). Conclusion Trans-PRK may offer an effective and easier platform than conventional PRK in the treatment of mild and moderate myopia, and patients have better visual outcome, faster healing time, and less postoperative haze.


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