Efficacy And Predictability Of Photorefractive Keratectomy Enhancement After Primary Transepithelial Photorefractive Keratectomy: A Retrospective Study
Published 2024 - 42nd Congress of the ESCRS
Reference: PO1273 | Type: Free paper | DOI: 10.82333/svdc-8x90
Authors: Shuang-An Yang* 1 , Shih-Yi Wang 1 , Shu-Yun Yang 2 , Lin-Chung Woung 3
1Ophthalmology,Taipei City Hospital Renai Branch,Taipei City,Taiwan, Province of China, 2Ophthalmology,Changhua Christian Hospital,Changhua City,Taiwan, Province of China, 3Ophthalmology,Taipei City Hospital Renai Branch,Taipei City,Taiwan, Province of China;Ophthalmology,WishVision Eye Center,Taipei City & Taichung City,Taiwan, Province of China
Purpose
To evaluate the efficacy and predictability of Photorefractive Keratectomy (PRK) enhancement in patients with residual refractive error after primary transepithelial PRK (transPRK).
Setting
A retrospective cohort study in Taiwan
Methods
This retrospective, two-site study reviewed all cases of primary PRK at WishVision Eye Center in Taiwan between Feb, 2017 and Mar, 2023 to identify any case that required follow-up enhancement. Both primary PRK and PRK enhancement were performed with SMART transPRK, using an Amaris 1050RS excimer laser with innovative smart pulse technology. The primary outcomes were efficacy and predictability. Multivariate logistic regression models were used to determine factors predictive of PRK enhancement.
Results
Out of the 8,709 eyes, 153 eyes required transPRK enhancement, with an enhancement rate of 1.76 %. At post-operative 12-month, uncorrected distance visual acuity (UDVA) of 20/20 or better was achieved in 98% of eyes with corrected distance visual acuity (CDVA) of 20/20 or better preoperatively. Manifest refraction spherical equivalent (MRSE) was significantly reduced from pre-enhancement values of -0.46 ± 0.06 D to -0.21 ± 0.06D with 54% and 75% of eyes achieving MRSE within ±0.50 D and ±1.00 D of target, respectively. Besides, age older than 40 years, preoperative MRSE more than -6.00 diopters (D), and worse CDVA were all significant risk factors of PRK enhancement after adjustment (adjHR,4.10,2.08,and 24.23 respectively; all P<0.001).
Conclusions
Our results demonstrate that SMART transPRK enhancement received good efficacy and predictability which exceeds the FDA criteria for the correction of refractive error. Besides, older age, female, worse CDVA, and higher preoperative sphere, cylinder, and MRSE at primary PRK were all associated with higher risk of PRK enhancement.