Comparison between Transepithelial Photorefractive keratectomy (TPRK) and Alcohol assisted Photorefractive Keratectomy(PRK) .A retrospective study.

Abstract

Purpose: To compare the postoperative visual outcome, patient comfort and safety after surgery between transepithelial photorefractive keratectomy (PRK) and alcohol-assisted PRK in two groups of patients.

Setting:  Maharajahs Institute of Medical Sciences, Nellimarla,Andhra Pradesh, India

Design: Retrospective study.

Methods: Patients were randomized into two groups,one group of patients underwent  transepithelial PRK in both eyes and  second group of patients underwent alcohol-assisted PRK in both eyes.All surgeries were performed by single surgeon(Author) during a period of 6 months from January 2023 to June 2023. In all the patients aspheric treatments were planned with Custom Ablation Manager software and ablations performed with the Schwind Amaris system. Clinical outcomes were patient comfort, refraction, visual acuity. Paired t tests were applied for statistics.

Results: The study evaluated 100 eyes(50 patients) in each group. All patients completed 6 months follow-up. At 6 months, 99% of eyes in both groups achieved an uncorrected distance visual acuity (UDVA) of 0.1 logMAR or better. No eye lost 2 or more lines of corrected distance visual acuity (CDVA); 99% of transepithelial PRK eyes and 99% of alcohol-assisted PRK eyes were within ±0.50 diopter (D) of the targeted refraction. The postoperative mean spherical equivalent was +0.03 D ± 0.23 (SD) and +0.01 ± 0.26 (SD) respectively.

Conclusions: The CDVA, UDVA, and safety outcomes between transepithelial PRK and alcohol-assisted PRK were comparable. Transepithelial PRK is faster to perform and it is an all-laser procedure, which might be less stressful for the patient. Patients who underwent transepithelial PRK had less discomfort after surgery compared to alcohol assisted PRK patients who complained of discomfort for around two days on average after surgery.