Impact Of Routine Sterile Eyelid Draping On Complications And Clinical Outcomes In Prk And Lasik: A Large Propensity-Matched Analysis
Published 2026 - 44th Congress of the ESCRS
Reference: FP07.10 | Type: Free paper | DOI: 10.82333/zkmr-k160
Authors: Dr Daniel Bahir* 1 , Dr Dror Ben Ephraim Noyman 2 , Mr Tzahi Sela 3 , Mr Gur Munzer 3 , A/Prof. Igor Kaiserman 4 , A/Prof. Michael Mimouni 2
1Ophthalmology,Tzafon Medical Center,Poriya,Israel, 2Ophthalmology,Rambam Health Care Campus,Haifa,Israel, 3Care-Vision Laser Center,Tel-Aviv,Israel, 4Ophthalmology,Barzilai Medical Center,Ashkelon,Israel
Purpose
To determine whether routine sterile eyelid draping meaningfully reduces inflammatory or infectious complications in laser vision correction and to evaluate its effect on visual, refractive and epithelial healing outcomes in PRK and LASIK.
Setting
High-volume tertiary laser vision correction center, Tel Aviv, Israel.
Methods
Retrospective comparative analysis of consecutive primary PRK and LASIK procedures performed between 2021 and 2024. Eyes were stratified according to use of sterile eyelid draping. Propensity score matching was performed based on age, sex, pachymetry, keratometry and preoperative spherical equivalent. Primary endpoints were diffuse lamellar keratitis (DLK), infectious keratitis and epithelial recovery. Secondary endpoints included uncorrected and corrected distance visual acuity, spherical equivalent accuracy, and safety and efficacy indices. Multivariable linear and logistic regression models were used to adjust for intraoperative variables including optical zone diameter, ablation depth, temperature and operative time.
Results
After matching, 6,129 eyes were included (1,483 LASIK; 4,646 PRK). In LASIK, DLK rates were low and comparable between groups (0.2% with draping vs 0.5% without; p=0.67). No infectious keratitis occurred in either cohort. Overall complication rates were similar (2.3% vs 2.4%; p>0.99). In PRK, no infectious keratitis was observed. However, delayed epithelial recovery was significantly more frequent in the draped group (3.0% vs 1.1%; p<0.001), with a corresponding increase in overall complication rates (3.9% vs 1.9%; p<0.001). Despite statistical differences in select refractive parameters, safety and efficacy indices remained high and clinically equivalent across groups.
Conclusions
Routine sterile eyelid draping did not reduce DLK or infectious keratitis in either PRK or LASIK. In PRK, draping was associated with increased delayed epithelial healing and higher overall complication rates. These findings challenge the presumed protective value of routine draping in modern refractive surgery. Beyond clinical implications, elimination of unnecessary disposable draping materials may reduce surgical waste and improve the environmental sustainability of high-volume refractive practice.