Comparison between Transepithelial Photorefractive Keratectomy versus Alcohol-Assisted Photorefractive Keratectomy in Correction of Myopia and Myopic Astigmatism

Ashraf M Bakhsh, Shaaban A M Elwan, Ahsan A Chaudhry, Tamer M El-Atris, Taghleb M Al-Howish, Ashraf M Bakhsh, Shaaban A M Elwan, Ahsan A Chaudhry, Tamer M El-Atris, Taghleb M Al-Howish

Abstract

Purpose: The aim of the study was to compare visual acuity, refractive results, safety, and efficacy of TPRK with AAPRK as primary outcomes and surgical time, pain scores, haze levels, and healing time as secondary outcomes in TPRK and AAPRK groups.

Setting: Security Forces Hospital, Ophthalmology Department, Riyadh, Kingdom of Saudi Arabia.

Design: Prospective, nonrandomized case-control comparative study.

Methods: A total of 200 eyes of 100 consecutive patients were included. One hundred eyes underwent TPRK in the right eye (study group), and 100 eyes underwent AAPRK in the left eye (control group). Ablations were performed with the Schwind Amaris excimer LASER750S. Clinical outcomes during 6 months' follow-up were compared.

Results: The mean age of patients was 28.3 ± 6.3, 77 were females and 23 males. The mean surgical time was 162.17 ± 14.827 s and 243.24 ± 98.69 s, respectively. At day 1, the UDVA mean was 0.7 in 87% of eyes in the TPRK group while it was 0.5 in 45% of eyes in AAPRK; at week 1, it was 0.9 in 88% of eyes in the TPRK group and 0.6 in 60% of eyes in AAPRK. The mean pain scores were less and lower incidence of corneal haze in the TPRK. Complete epithelial healing time was shorter in TPRK, 3.20 ± 0.686 and 4.60 ± 1.969 days, respectively.

Conclusions: TPRK and AAPRK produce similar results 6 months postoperatively. However, in the early postoperative period, there were significant differences in UDVA, pain score, level of haze, and complete epithelial healing time. The pain scores were lower, level of haze was less, and healing time was shorter in the TPRK group which provided patient better felling and comfort in this period. Both of procedures are effective and safe for correction of myopia and compound myopic astigmatism. This trial is registered with NCT03569423.

Figures

Figure 1
Figure 1
Manifest refraction spherical equivalent (MRSE) in TPRK and AAPRK groups. Data are expressed as means ± SD.
Figure 2
Figure 2
(a) Preoperative and postoperative uncorrected distant visual acuity (UDVA) in decimal values in both groups. (b) The postoperative UDVA percentage of eyes improvement over time in both groups. Data are expressed as means ± SD.
Figure 3
Figure 3
The mean postoperative pain scores in both groups. Data are expressed as means ± SD.
Figure 4
Figure 4
The mean level of haze according to Fantes scores in both groups. Data are expressed as means ± SD.
Figure 5
Figure 5
Percentage of eyes with complete corneal epithelial healing on the third postoperative day. Data are expressed as means ± SD.

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Source: PubMed

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