Clinical outcomes of single-step transepithelial photorefractive keratectomy and off-flap epipolis-laser in situ keratomileusis in moderate to high myopia: 12-month follow-up

Yunjie Zhang, Tiankun Li, Zhangliang Li, Mali Dai, Qinmei Wang, Chenchen Xu, Yunjie Zhang, Tiankun Li, Zhangliang Li, Mali Dai, Qinmei Wang, Chenchen Xu

Abstract

Background: To compare the quantitative and qualitative optical outcomes of single-step transepithelial photorefractive keratectomy (TPRK) and off-flap epipolis-laser in situ keratomileusis (Epi-LASIK) in moderate to high myopia.

Methods: In this prospective self-control study, we included patients with moderate to high myopia who were randomized to undergo TPRK in one eye and Epi-LASIK in the other eye. Twelve-month follow-up results for visual acuity, refraction, ocular high-order aberrations, contrast sensitivity, postoperative pain, epithelial healing, and haze grade were assessed.

Results: A total of 64 eyes (32 patients) were enrolled in the study. More eyes completed re-epithelialization in the TPRK group than in the Off-flap Epi-LASIK group 3-4 days postoperatively, while all eyes completed re-epithelialization by 7 days. More eyes achieved a visual acuity (both UDVA and CDVA) of better than 20/20 in the TPRK group than in the Off-flap Epi-LASIK group. The ±0.50 D predictability for correction of the spherical equivalent (SE) was higher in the eyes of the TPRK group (91%) than in those of the off-flap Epi-LASIK group (80%) 12 months after surgery. No significant differences in ocular aberrations, including coma, spherical, and trefoil, were found between the two groups at 12 months. There were also no significant differences in visual acuity, contrast sensitivity, pain, and haze grading between the two groups.

Conclusions: Both TPRK and off-flap Epi-LASIK are safe, effective, and predictable treatments for moderate to high myopia with comparable surgical outcomes.

Trial registration: This study was retrospectively registered on ClinicalTrial.gov ( NCT05060094 , 17/09/2021).

Keywords: Epipolis-laser in situ keratomileusis; Higher-order aberrations; Transepithelial photorefractive keratectomy.

Conflict of interest statement

The authors have no proprietary or commercial interest in any materials discussed in this article.

© 2022. The Author(s).

Figures

Fig. 1
Fig. 1
Visual outcomes after single-step transepithelial photorefractive keratectomy (TPRK) and off-flap epipolis-laser in situ keratomileusis (Epi-LASIK). A: cumulative 12-month postoperative uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA); Changes in the Snellen lines of postoperative UDVA (B) and CDVA (C), compared with preoperative CDVA; D: accuracy of spherical equivalent refraction; E: attempted versus achieved changes in spherical equivalent refraction; F: distribution of preoperative and 12-month postoperative cylinder
Fig. 2
Fig. 2
Target-induced versus surgically-induced astigmatism vectors at 12 months postoperatively
Fig. 3
Fig. 3
Single-angle polar plots of the target-induced astigmatism vector and surgically induced astigmatism at 12 months postoperatively in the single-step transepithelial photorefractive keratectomy (TPRK) group (A, B) and off-flap epipolis-laser in situ keratomileusis (Epi-LASIK) group (C, D), respectively

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