Where Are We Now With Transepithelial Photorefractive Keratectomy?

The type and nature of refractive surgery procedures has greatly increased over the past decades, allowing for almost all patient populations to be treated to extremely high satisfaction. Conventional photorefractive keratectomy involves the removal of the corneal epithelium through mechanical debridement or dilute alcohol instillation. An improvement to this method utilises laser epithelial removal in a single step process termed transepithelial photorefractive keratectomy (transPRK).

We explore the history of transPRK from its early adoption as a two step process, identify different transPRK platforms from major manufacturers and describe the role of transPRK in the refractive surgery armamentarium.

Narrative review of the literature.

Though often not seen as a primary treatment option when compared to other corneal based procedures that offer a faster and more comfortable recovery, there are many scenarios in which these procedures are not possible. These include, but are not limited to, cases of corneal instability, previous refractive surgery or transplant where higher order aberrations can impair vision in a manner not amenable to spectacle or contact lens correction. Modern transepithelial PRK using advanced laser platforms and ablation profiles will provide highly accurate treatments across a wide variety of refractive error. Further work to optimise postoperative comfort in particular after surgery is welcome.