Conventional PRK versus single-step transPRK in corneal refractive surgery with excimer laser

Abstract

Objective: To compare conventional alcohol-assisted PRK (aaPRK) and single-step transPRK in terms of clinical-refractive and surgical variables.

Method: An observational, prospective, longitudinal study was carried out in 72 patients who were candidates for corneal refractive surgery with the excimer laser, with a diagnosis of compound myopic astigmatism, at the Exilaser Ophthalmological Center, Cuenca, Ecuador, from September to December 2019. Patients underwent surface surgery (transPRK or aaPRK). Data processing was performed with the SPSS program, version 21.0. For data comparison between both surgical techniques, the chi-square test was used, where P < 0.05 was considered statistically significant.

Results: The average spherical equivalent was obtained for aaPRK (−0.14) and transPRK (−0.11) 3 months after the procedure (p = 0.34). UCVA average was 0.93 in aaPRK and 0.96 in transPRK, without statistically significant differences (p = 0.63). Surgical time was shorter in transPRK (720.31 s) compared to aaPRK (1080.85 s), with a statistically significant difference (p < 0.001). In transPRK there was less pain immediately after surgery, compared to aaPRK (p <0.05). Epithelial closure was achieved on day 6.27 for aaPRK and in day 3.62 for transPRK (average values; p = 0.02).

Conclusions: Single-step transepithelial PRK and aaPRK in patients who are candidates for refractive surgery showed very similar results 3 months after surgery in terms of uncorrected visual acuity, spherical equivalent and with minimal postoperative complications. TransPRK offers greater advantages to the patient regarding shorter surgical time, rapid epithelial closure and less pain in the immediate postoperative period.