Outcomes Of Transepithelial Prk And Regular Prk

To report on clinical outcomes of transepithelial photorefractive keratectomy (TransEpi PRK) and regular PRK performed with TENEO 317 Model 2 Excimer Laser Platform.

Clinica La Paloma, Las Palmas de Gran Canaria, Spain

This data collection includes 402 eyes from 223 patients. The TransEpi PRK group consists of 292 eyes from 162 patients and 110 eyes from 82 patients underwent regular PRK treatment. Apart from a few exceptions, subjects showing moderate to large refractive error (>2.0 D) were treated with TransEpi PRK, subjects presenting low refractive error (<2.0 D) underwent regular PRK treatment. Data were available preoperatively and up to 6 months postoperatively. The examinations included manifest refraction as well as monocular visual acuity (VA) data on uncorrected distance visual acuity (UDVA) and best-corrected distance visual acuity (BCDVA). For both groups a plano refraction was targeted. VA outcomes were not available for all subjects.

The manifest spherical equivalent (SE) improved from -1.97±1.35 D (-8.00 to -0.63 D) preoperatively to 0.01±0.48 D (-1.00 to 1.50 D) 6 months postoperatively for the PRK group (p<.001). In TransEpi eyes, SE improved from -4.36±1.94 D (-10.50 to -0.38 D) preoperatively to -0.05±0.50 D (-1.50 to 1.00 D) after 6 months (p<.001). For the PRK group, 80.2% of eyes were within ±0.5 D of their intended postoperative SE. For the TransEpi group it was 77.0% of eyes after 1 month. Residual refractive cylinder of ≤0.50 D was achieved in 43% of the PRK eyes and 47% of TransEpi eyes group. At 6 months postoperatively, 90% of eyes (31 eyes) presented with UDVA of 0.0 logMAR or better in the PRK group and 90% (62 eyes) in the TransEpi group.

Overall, the clinical outcomes for both groups were very satisfying. Refractive outcomes were close to plano for both groups. Both groups show similar good visual outcomes with UDVA of 0.0 logMAR or better for almost all treated eyes. These outcomes are especially interesting considering that the TransEpi group consisted of eyes with larger refractive errors preoperatively than eyes in the PRK group.

Both treatment techniques have their field of application. However, one advantage of TransEpi PRK is a reduced chair time in the OR by using one single laser treatment. Also, the authors observe, that TransEpi PRK seems to be less painful and has a faster recovery time. However, this needs to be confirmed in more clinical trials.