ESCRS - PO777 - An Evaluation Of Early Symptoms After Transepithelial Photorefractive Keratectomy (Prk) Compared To Alcohol-Assisted Prk

An Evaluation Of Early Symptoms After Transepithelial Photorefractive Keratectomy (Prk) Compared To Alcohol-Assisted Prk

Published 2025 - 43rd Congress of the ESCRS

Reference: PO777 | Type: Free paper | DOI: 10.82333/v71n-2571

Authors: Xiteng Chen* ¹ , Fang Tian ¹

¹Tianjin Medical University Eye Hospital,Tianjin,China

Purpose

Current evidence on the advantages of StreamLight TransPRK remains limited, and its impact on post-operative comfort is unclear. This study evaluates pain, photophobia, tearing, and foreign body sensation in patients undergoing StreamLight TransPRK for myopia or myopic astigmatism, comparing outcomes to those of traditional Alcohol Assisted-PRK (AA-PRK), performed with the same excimer laser and surgeon.

Setting

Private high-volume refractive surgery clinic in Medellín, Colombia

Methods

This retrospective study analyzed patients undergoing excimer laser correction for myopia or myopic astigmatism. Inclusion required age ≥21 years and no ocular or systemic disease beyond refractive error. Patients underwent full preoperative evaluations, and surgeries (AA-PRK or TransPRK) were performed using the WaveLight EX500 laser. Symptom tracking was conducted via 15 phone calls over five days, with a call made every 8 hours, assessing pain, photophobia, tearing, and foreign body sensation. Statistical analysis included mixed ANOVA models with corrections for sphericity violations. Ethical approval was obtained, and anonymity was maintained per the Declaration of Helsinki.

Results

This study included 118 patients (65.25% female, median age 27). Of these, 33.05% underwent TransPRK and 66.95% AA-PRK, with no significant differences in baseline characteristics.

Pain levels showed no interaction between surgery type and time (p = 0.682). Photophobia was lower in TransPRK at 24 hours (p = 0.038) but higher at 112 and 120 hours (p < 0.05). Tearing levels showed no significant interaction (p = 0.161). Foreign body sensation was lower in TransPRK at 24, 32, 40, and 56 hours (p < 0.05). Time significantly affected all symptoms, while surgery type had a limited effect.

Conclusions

TransPRK seems to provide a very short-lived and probably clinically insignificant improvement in foreign body sensation for the first two days when compared to patients undergoing AA-PRK. There don’t seem to be differences regarding pain levels, tearing levels or refractive endpoints. It is up to the surgeon to decide whether the small clinical differences justify the decision to perform one ablation approach over the other.