Comparative Analysis Of Expanded Optical Zone Trans-Prk, Conventional Trans-Prk, And Lenticule Intrastromal Extraction In Reducing Postoperative Glare And Halo
Published 2025 - 43rd Congress of the ESCRS
Reference: PP21.15 | Type: Free paper | DOI: 10.82333/1x5z-hf40
Authors: Gerd Uwe Auffarth* 1 , Claudette Abela-Formanek 2 , Allon Barsam 3 , Başak Bostanci 4 , Francesco Carones 5 , Dean Corbett 6 , Tiago Ferreira 7 , Fernando Llovet 8 , Sanjay Mantry 9 , Alain Saad 10
1Dept of Ophthalmology,University of Heidelberg,Heidelberg,Germany, 2Department of Ophthalmology and Optometry ,Medical University of Vienna,Vienna,Austria, 3OCL Vision,London,United Kingdom, 4Suadiye Dünya Göz Hastanesi,Bahçeşehir Üniversitesi Tıp Fakültesi,Istambul,Türkiye, 5ADVALIA Vision,Milan,Italy, 6Auckland Eye,Auckland,New Zealand, 7Clínica Privada de Oftalmologia,Lisbon,Portugal, 8Clinica Baviera Aier Group,Valencia,Spain, 9Vision Scotland,Edinburgh,United Kingdom, 10Rothschild Foundation ,Paris,France
Purpose
To evaluate the efficacy of an expanded optical zone (OZ) in transepithelial photorefractive keratectomy (Trans-PRK) for reducing postoperative glare and halo compared to conventional Trans-PRK and lenticule intrastromal extraction surgery.
Setting
A retrospective study conducted at an ophthalmology center specializing in refractive surgery.
Methods
A retrospective comparative study was conducted on patients undergoing refractive surgery for myopia and myopic astigmatism. Patients were categorized into three groups based on the surgical procedure:
Expanded OZ Trans-PRK (≥8 mm total ablation zone)
Conventional Trans-PRK (<8 mm total ablation zone)
Lenticule intrastromal extraction (e.g., SMILE)
Preoperative and postoperative visual outcomes, higher-order aberrations (HOAs), root mean square values at 5 mm and 6 mm zones (RMS5, RMS6), and patient-reported glare and halo symptoms were assessed over a six-month follow-up period. Statistical comparisons were made using ANOVA and post hoc Tukey tests to determine significant differences among the groups.
Results
All three groups achieved comparable uncorrected distance visual acuity (UDVA) and best-corrected distance visual acuity (BDVA) postoperatively (p > 0.05).
The expanded OZ Trans-PRK group demonstrated significantly lower postoperative HOAs, especially spherical aberration, compared to both the conventional Trans-PRK and lenticule extraction groups (p < 0.01).
RMS5 and RMS6 values were lowest in the expanded OZ Trans-PRK group, indicating improved optical quality (p < 0.05).
Subjective reports of glare and halo were significantly reduced in the expanded OZ Trans-PRK group compared to the other two groups, as measured by patient-reported outcome surveys (p < 0.01).
Conclusions
The findings suggest that Trans-PRK with an expanded optical zone provides superior postoperative visual quality, reducing glare and halo more effectively than conventional Trans-PRK and lenticule intrastromal extraction surgery. The improved optical performance is likely due to reduced spherical aberration and better preservation of corneal asphericity. These results support the consideration of an expanded OZ in Trans-PRK as an optimized approach for patients prone to night vision disturbances.