Comparison of Three Epithelial Removal Techniques in PRK: Mechanical, Alcohol-assisted, and Transepithelial Laser.

To compare the visual and refractive results obtained after photorefractive keratectomy (PRK) in patients who underwent one of three different epithelial removal techniques. The authors reviewed the medical files of consecutive eyes with myopia and myopic astigmatism that were treated during a 10-year period by mechanical PRK, alcohol-assisted PRK, or transepithelial PRK (in the phototherapeutic keratectomy mode), and observed for more than 1 year. A total of 3,417 patients (3,417 eyes) were included in this study. At 3 and 6 months postoperatively, the outcome of alcohol-assisted PRK was superior both in efficacy (P < .01) and safety (P < .001) to those of both mechanical PRK and transepithelial PRK, which were similar. At more than 1 year postoperatively, the mean efficacy index was still high for alcohol-assisted PRK, but low for the transepithelial PRK, corresponding to a mean uncorrected visual acuity of more than one Snellen line lower than those of the other two techniques (P < .0001). All three techniques showed a regression toward myopia more than 1 year postoperatively, with significant undercorrection obtained in eyes treated with transepithelial PRK (P < .0001). Significant differences were detected in both the visual outcomes and the refractive results of the three epithelial removal techniques. The long-term outcomes were best for alcohol-assisted PRK.

Shapira Y ，Mimouni M ，Levartovsky S ，Varssano D ，Sela T ，Munzer G ，Kaiserman I ... -  《-》

Consecutive myopia correction with transepithelial versus alcohol-assisted photorefractive keratectomy in contralateral eyes: one-year results.

To compare the postoperative efficacy, safety, and higher-order-aberrations (HOAs) between transepithelial photorefractive keratectomy (PRK) and alcohol-assisted PRK in contralateral eyes. Private clinic, Utrecht, The Netherlands. Comparative case series. Consecutive patients were randomized to have transepithelial PRK in 1 eye and alcohol-assisted PRK in the contralateral eye. In both eyes, aspheric treatments were planned with Custom Ablation Manager software and ablations performed with the Schwind Amaris system. Clinical outcomes were predictability, refraction, visual acuity, wavefront aberrations, and contrast and glare sensitivity. Paired t tests were applied for statistics. The study evaluated 66 eyes (33 patients). All patients completed the 1-year follow-up. At 1-year, 97% of eyes in both groups achieved an uncorrected distance visual acuity (UDVA) of 0.1 logMAR or better. No eye lost 2 or more lines of corrected distance visual acuity (CDVA); 97% of transepithelial PRK eyes and 91% of alcohol-assisted PRK eyes were within ±0.50 diopter (D) of the targeted refraction. The postoperative mean spherical equivalent was +0.07 D ± 0.23 (SD) and +0.01 ± 0.27 D, respectively. The CDVA, UDVA, and safety outcomes between transepithelial PRK and alcohol-assisted PRK were comparable. Profiles for both techniques applied to regular corneas preserved the eye's natural HOAs. Transepithelial PRK is faster to perform and it is an all-laser procedure, which might be less stressful for the patient. Mr. Ewering and Mr. Arba-Mosquera are employees of Schwind eye-tech-solutions. Dr. Luger has no financial or proprietary interest in any material or method mentioned.

Luger MH ，Ewering T ，Arba-Mosquera S 《-》

Epithelial Erosions and Refractive Results After Single-Step Transepithelial Photorefractive Keratectomy and Alcohol-Assisted Photorefractive Keratectomy in Myopic Eyes: A Comparative Evaluation Over 12 Months.

Fattah MA ，Antonios R ，Arba Mosquera S ，Abiad B ，Awwad ST ... -  《-》

Epithelial healing and clinical outcomes in excimer laser photorefractive surgery following three epithelial removal techniques: mechanical, alcohol, and excimer laser.

Lee HK ，Lee KS ，Kim JK ，Kim HC ，Seo KR ，Kim EK ... -  《-》

Comparison of visual and refractive results after transepithelial and mechanical photorefractive keratectomy in myopia.

Yildirim Y ，Olcucu O ，Alagoz N ，Agca A ，Karakucuk Y ，Demirok A ... -  《-》