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Comparison of Epi-Bowman Keratectomy with alcohol-assisted PRK

Poster Details

First Author: S.Taneri GERMANY

Co Author(s):    S. Oehler   H. Dick           

Abstract Details

Purpose:

In Epi-Bowman Keratectomy (EBK™) a new dynamic multi-blade polymer epikeratome (Epi-Clear™, Orca Surgical, Kiryat-Shmona, Israel) is utilized to remove the epithelium by sweeping movements across the corneal surface until Bowman’s layer is reached. Discarded epithelial cells are collected inside the tip of the instrument and are not repositioned at the end of the procedure. Alcohol is not utilized. We wanted to compare clinical results of this new treatment modality to alcohol-assisted PRK with a discarded flap, the gold standard for surface ablations at our institution.

Setting:

1 Zentrum für Refraktive Chirurgie, Augenabteilung am St. Franziskus Hospital Münster; 2 Ruhr University Bochum

Methods:

Adult patients seeking ametropia correction without ocular diseases or prior surgery were included in this observational case series. Sixty-seven consecutive low to moderate ametropic eyes (36 patients) were treated with EBKTM. Twenty eyes of 20 patients were treated with alcohol-assisted PRK. In both groups every eye was cooled with isotonic salt solution immediately after ablation and received a bandage contact lens (Pure Vision, Bausch&Lomb, Munich, Germany). Outcomes: Complications, visual acuity (decimal scale), diameter of epithelial defect (mm), pain score (subjective visual analogue scale, 0-10), and haze formation (Fantes scale, 0-3), spherical aberration (Zywave, Bausch&Lomb Technolas, Munich, Germany).

Results:

EBKTM : Uncorrected distance visual acuity (UDVA): 0.47/0.43/0.52/0.60/0.88/0.96; epithelial defect: 4.7/0.3/0.2/0/0/0; pain levels: 3.1/0.6/0/0/0/0 at day 1/3/4/1 week/1 month/3 months, respectively. Haze levels: 0.3/0.4 after 1 month/3 months, respectively. Efficacy was 0.87, spherical aberrations were unchanged at 3 months. Alcohol-assisted PRK: UDVA: 0.58/0.49/0.46/0.69/0.78/0.86/1.19 at day 1/2/3/4/1 week/1 month/3 months, respectively. Epithelial defect: 4.6/2.0/0.2/ at day 1/2/3, and 0 at every later follow-up, respectively. Pain levels: 2.4/2.3/0.8 at day 1/2/3 and 0 at every later follow-up, respectively. Haze levels: 0.7/0.1 after 1 month/ 3 months. Efficacy was 1.14 at 3 months.

Conclusions:

The new surface treatment modality EBK™ may avoid problems associated with the use of alcohol. It offered predictable and effective refractive outcomes. These results are similar to results after alcohol-assisted PRK, which has been the gold standard for surface ablations in our hands.

Financial Disclosure:

NONE

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