ESCRS - FPM03.02 - Minimally Invasive, By Customizing Epithelial Removal With Blunt Epi-Bowman's Keratectomy Photorefractive Keratectomy, A Single Arm Consecutive Case Series With One Year Follow-Up

Minimally Invasive, By Customizing Epithelial Removal With Blunt Epi-Bowman's Keratectomy Photorefractive Keratectomy, A Single Arm Consecutive Case Series With One Year Follow-Up

Published 2022 - 40th Congress of the ESCRS

Reference: FPM03.02 | Type: Free paper | DOI: 10.82333/0qhj-7j64

Authors: Anastasios John Kanellopoulos 1 , Dimitrios Machairas* 2

1Ophthalmology,LaserVision Ambulatory Eye Surgery Unit,Athens,Greece;Ophthalmology,NYU Med School,New York,United States, 2ophthalmology,LaserVision Ambulatory Eye Surgery Unit,Athens,Greece

Purpose

Customized PRK with minimized epithelial removal, may minimise pain and speed epithelialisation and visual recovery, compared to traditional larger-epithelial zone PRK and even more-recent trans-epithelial (laser-epithelial removal)-PRK employed for myopic laser vision correction. These data appear superior to LASIK and Smile for the immediate post-op rehabilitation and restrictions, similar in discomfort experienced with both of these lamellar procedures, with a potentially superior intra-operative safety profile.

Setting

From the  Laservision.gr Clinical and Research Eye Institute, Athens, Greece

Methods

120 patients (240 eyes) underwent customized PRK for myopia with custom-shape and diameter epithelial removal with the blunt EBK Orca device to match the dimentions of the EX500 excimer laser treatment plan. Bromfenac 0.9mg/ml was used in addition to the standard bandage contact lens, topical corticosteroid and antibiotic solution for the first postoperative day. Visual acuity, CDVA, UDVA, refraction, post-operative pain measured on a subjective scale, epithelial healing and epithelial mapping profile were evaluated for 12 months.

Results

In average the pain scores for the first postoperative 24 hours were 0.27 ± 0.15 (on a scale 0-4). Day 2 epi-defect was measured in average on the slitlamp: 1.52 ± 1.23 mm2. 25 eyes were not yet epithelialized by day 3, and none by day 4. 4 patients reported use of additional analgesia within the first 24 hours postop. All eyes were at least measured with UDVA 20/25 immediately after the procedure and all 20/25 by day 4. At 3 months UDVA was 20/15,5, Residual refractive error: -0.15 Diopters. Residual manifest cylinder -0.18 Diopters; high order aberrations: 0,21um.

Conclusions

This novel technique of minimal customized epithelial removal: mini-PRK, may minimize pain and visual debilitation, by accelerating re-epithelialization and early visual recovery. These data appear superior to LASIK and Smile for the immediate postop rehabilitation and restrictions. They appear similar in the level of minimal discomfort experienced with both of these lamellar procedures, with a potentially superior intra-operative safety profile.