Clinical Outcomes Of Topo-Guided Photorefractive Keratectomy In Treatment Naive Patients - A Comperative Study With Topo-Guided Lasik

To evaluate the refractive outcomes of Topo-guided Photorefractive Keratetomy using Wavelight Topolyzer VARIO based CONTOURA vision system in terms of refractive outcome, wound healing, pain intensity and visual recovery time and to compare the results with conventional PRK

The study was a prospective study done at a single tertiary eye hospital , over a period of 2 years. 100 eyes of 50 patients with mild to moderate myopia were included.

In our prospective clinical observational study 100 eyes of 50 patients with mild to moderate myopia were included. Out of these 50 eyes were subjected to Topography on Wavelight Topolyzer VARIO system. The sightmaps optained were used to perform PRK treatment after removing the epithlium with 0.5% proparacaine solution. In the other arm, 50 eyes were subjected to wavefront optimised tretament PRK after removing the epithelium. Visual acuity (LogMar) was recorded preoperatively and at week 1,4  and 24 weeks postoperatively. Wound healing (hours between surgery and complete epithelial closure) was monitored at the slit lamp. Pospoperative topography was done at 3 months to access the treatment centration and residual corneal abberations. 

Difference in Visual recovery was not significant in either of the group . At day 7, the mean monocular UCDVA was the same in the Epi Contoura group than in the PRK group with both groups averaging UCDVA of 0.63. However at 4 weeks, the monocular UCDVA was significantly better in Epi Contoura group as compared to PRK group (p<0.001). The mean UCDVA of Epi Contoura was 1.00 while that of PRK was 0.80. 60% of eyes in Epi Contoura were better than 1.00.At 24 weeks postoperatively, a mean UCDVA of 1.0 or better was achieved in both groups. Complete epithelial wound closure was achieved without any significant difference in 4 days in both groups.  No patient had lost a line of BCDVA and no complications or adverse effects were observed.

According to our clinical study, Topo guided PRK treatment using VARIO guided CONTOURA vision system offers superior visual results as compared to conventional wavefront optimised PRK treatment. Whilst CONTOURA LASIK ( topo guided LASIK) has been well defined, our study has demonstarated EPI CONTOURA ( topo guided PRK) as a viable treatment. We believe it can offer superior visual result as compared to conventional PRK.