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Giral JB, Bloch F, Sot M, Zevering Y, El Nar A, Vermion JC, Goetz C, Lhuillier L, Perone JM. Efficacy and safety of single-step transepithelial photorefractive keratectomy with the all-surface laser ablation SCHWIND platform without mitomycin-C for high myopia: A retrospective study of 69 eyes. PLoS One 2021; 16:e0259993. [PMID: 34874947 PMCID: PMC8651116 DOI: 10.1371/journal.pone.0259993] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 10/30/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Studies suggest that transepithelial photorefractive keratectomy (TransPRK) with the all-surface laser ablation (ASLA)-SCHWIND platform is effective and safe for both low-moderate myopia and high myopia. In most studies, mitomycin-C is administered immediately after surgery to prevent corneal opacification (haze), which is a significant complication of photorefractive keratectomy in general. However, there is evidence that adjuvant mitomycin-C induces endothelial cytotoxicity. Moreover, a recent study showed that omitting adjuvant mitomycin-C did not increase haze in low-moderate myopia. The present case-series study examined the efficacy, safety, and haze rates of eyes with high myopia that underwent ASLA-SCHWIND TransPRK without adjuvant mitomycin-C. METHODS All consecutive eyes with high myopia (≤-6 D) that were treated in 2018-2020 with the SCHWIND Amaris 500E® TransPRK excimer laser without adjuvant mitomycin-C in a tertiary-care hospital (France) and were followed up for 6 months were identified. Uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), and spherical equivalent (SE) were recorded before and after surgery. Postoperative haze was graded using the 4-grade Fantes scale. Efficacy rate (frequency of eyes with 6-month UCVA ≤0.1 logMAR), safety rate (frequency of eyes that lost <2 BSCVA lines), predictability (frequency of eyes with 6-month SE equal to target SE±0.5 D), efficacy index (mean UCVA at 6 months/preoperative BSCVA), and safety index (BSCVA at 6 months/preoperative BSCVA) were computed. RESULTS Sixty-nine eyes (38 patients) were included. Mean preoperative and 6-month SE were -7.44 and -0.05 D, respectively. Mean 6-month UCVA and BSCVA were 0.00 and -0.02 logMAR, respectively. Efficacy rate and index were 95.7% and 1.08, respectively. Safety rate and index were 95.7% and 1.13, respectively. Predictability was 85.5%. Grade 3-4 haze never arose. At 6 months, the haze rate was zero. CONCLUSIONS ASLA-SCHWIND TransPRK without mitomycin-C appears to be safe as well as effective and accurate for high myopia.
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Affiliation(s)
- Jean Baptiste Giral
- Department of Ophthalmology, Metz-Thionville Regional Hospital Center, University of Lorraine, Mercy Hospital, Metz, France
| | - Florian Bloch
- Department of Ophthalmology, Metz-Thionville Regional Hospital Center, University of Lorraine, Mercy Hospital, Metz, France
| | - Maxime Sot
- Department of Ophthalmology, Metz-Thionville Regional Hospital Center, University of Lorraine, Mercy Hospital, Metz, France
| | - Yinka Zevering
- Department of Ophthalmology, Metz-Thionville Regional Hospital Center, University of Lorraine, Mercy Hospital, Metz, France
| | - Arpine El Nar
- Clinical Research Support Unit, Metz-Thionville Regional Hospital Center, University of Lorraine, Mercy Hospital, Metz, France
| | - Jean Charles Vermion
- Department of Ophthalmology, Metz-Thionville Regional Hospital Center, University of Lorraine, Mercy Hospital, Metz, France
| | - Christophe Goetz
- Clinical Research Support Unit, Metz-Thionville Regional Hospital Center, University of Lorraine, Mercy Hospital, Metz, France
| | - Louis Lhuillier
- Department of Ophthalmology, Metz-Thionville Regional Hospital Center, University of Lorraine, Mercy Hospital, Metz, France
| | - Jean-Marc Perone
- Department of Ophthalmology, Metz-Thionville Regional Hospital Center, University of Lorraine, Mercy Hospital, Metz, France
- * E-mail:
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Alasmari M, M Alfawaz A. Transepithelial photorefractive keratectomy to treat mild myopia. Int Ophthalmol 2021; 41:2575-2583. [PMID: 33761045 DOI: 10.1007/s10792-021-01816-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Accepted: 03/11/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE To assess the safety and effectiveness of transepithelial photorefractive keratectomy (T-PRK) in patients with mild myopia using the Schwind Amaris 750 s Excimer laser system which take corneal epithelium variability in consideration during ablation. METHODS A prospective case series study of patients with mild myopia with or without astigmatism (spherical equivalent ≤ -3 diopters), who underwent T-PRK as a single-step treatment, was carried out at King Abdulaziz University Hospital, Riyadh between May 2017 and January 2018. The main outcomes included postoperative uncorrected distance visual acuity (UDVA), residual refraction (manifest refraction) and complications. RESULTS A total of 42 patients (84 eyes) underwent bilateral T-PRK with a preoperative spherical equivalent ranging from - 0.75 to - 3.00 D. Median spherical equivalent before Trans-PRK was - 1.75 (- 1.25to - 1.75). The spherical equivalent six months after Trans-PRK was 0.0 (- 0.25 to 0.5). All patients had a postoperative UDVA of 20/20 or better in the last follow-up. Transient postoperative corneal haze was observed in five eyes (6%). CONCLUSION T-PRK appears to be safe and effective in patients who have mild myopia, with or without astigmatism. The normal variation in corneal epithelial thickness seems not to affect the outcomes.
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Affiliation(s)
- Mohammed Alasmari
- Department of Ophthalmology, College of Medicine, King Saud University, Airport Road, P.O. Box 245, Riyadh, 11411, Saudi Arabia
| | - Abdullah M Alfawaz
- Department of Ophthalmology, College of Medicine, King Saud University, Airport Road, P.O. Box 245, Riyadh, 11411, Saudi Arabia.
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Qian Y, Zhao P, Li H, Ye H. Transepithelial phototherapeutic keratectomy for the treatment of severe band keratopathy. Int Ophthalmol 2020; 40:2469-2474. [PMID: 32914278 DOI: 10.1007/s10792-020-01574-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 05/12/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE The goal of this study was to investigate the clinical outcomes of transepithelial phototherapeutic keratectomy (transepithelial PTK) for the treatment of severe band keratopathy. METHODS A consecutive series of severe band keratopathy cases treated with transepithelial PTK were retrospectively analysed between January 2018 and December 2019. Severe band keratopathy was defined as corneal plaques apparent in the obscuration of iris details. Patients' medical histories, preoperative and postoperative symptomatic relief, cosmesis, best-corrected visual acuity (BCVA), complications, and recurrences were analysed. RESULTS Seventeen eyes of 16 patients were included in the study, with a mean follow-up of 9.8 ± 5.2 months (3 to 19 months). The mean age of the patients was 15.8 ± 10.2 years (8 to 46 years). Symptoms were significantly or completely relieved in all patients (100%). The results of cosmesis were good in 14 eyes (82.4%). Among those eyes that had BCVA of hand motion or better preoperatively, seven eyes (100%) showed an improvement in BCVA postoperatively. There were no complications or recurrences associated with transepithelial PTK treatment during the follow-up period. CONCLUSIONS Transepithelial PTK is an effective treatment to eliminate corneal opacity and alleviate symptoms in patients with severe band keratopathy. This technique could be an alternative approach to managing severe band keratopathy.
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Affiliation(s)
- Yiyong Qian
- Department of Ophthalmology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Peiquan Zhao
- Department of Ophthalmology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Rd, Shanghai, 200092, People's Republic of China
| | - Haiyan Li
- Department of Ophthalmology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Rd, Shanghai, 200092, People's Republic of China
| | - Hehua Ye
- Department of Ophthalmology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Rd, Shanghai, 200092, People's Republic of China.
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Zhang J, Feng Q, Ding W, Peng Y, Long K. Comparison of clinical results between trans-PRK and femtosecond LASIK for correction of high myopia. BMC Ophthalmol 2020; 20:243. [PMID: 32560634 PMCID: PMC7304146 DOI: 10.1186/s12886-020-01515-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 06/12/2020] [Indexed: 11/17/2022] Open
Abstract
Background To compare the clinical outcomes of transepithelial photorefractive keratectomy (TPRK) with femtosecond laser-assisted in situ keratomileusis (FS-LASIK) for correction of high myopia. Methods In this prospective, non-randomised, cohort study, 85 eyes of 46 patients treated with TPRK and 80 eyes of 42 patients treated with FS-LASIK were included. All eyes were highly myopic (spherical equivalent refraction <− 6.00 diopters). Both TPRK and FS-LASIK were performed by Schwind Amaris 750S excimer laser. Visual acuity, refraction, corneal high order aberration (HOA) and other variables were analyzed before and at 1, 3, 6, 12 months after surgery. Results At 12 months after surgery, uncorrected logMAR distance visual acuity (UDVA) in the TPRK and FS-LASIK groups was − 0.04 ± 0.04 and − 0.01 ± 0.08, respectively (P = 0.039). Corrected logMAR distance visual acuity (CDVA) was − 0.06 ± 0.05 and − 0.04 ± 0.05 in both groups (P = 0.621). For UDVA, 86% of eyes in the TPRK group and 80% in the FS-LASIK group remained unchanged or improved one or more logMAR lines (P = 0.314), compared to preoperative CDVA. For CDVA, 97% of eyes in the TPRK group and 90% in the FS-LASIK group remained unchanged or improved one or more lines (P = 0.096), compared to preoperative CDVA. Spherical equivalent refraction was − 0.05 ± 0.39 and − 0.26 ± 0.47 in both groups (P = 0.030). 87% of eyes in the TPRK group and 73% in the FS-LASIK group achieved ±0.50 D target refraction (P = 0.019). All 85 eyes (100%) in the TPRK group and 75 eyes (92%) in the FS-LASIK group were within ±1.00 D of target (P = 0.003). Root mean square (RMS) of corneal total HOA and vertical coma in the TPRK group were lower compared with the FS-LASIK group (P < 0.001 for both variables). Conclusions TPRK and FS-LASIK showed good safety, efficacy and predictability for correction of high myopia. Clinical outcomes of TPRK were slightly better than FS-LASIK.
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Affiliation(s)
- Jiafan Zhang
- Qingdao Eye Hospital, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, 266071, Shandong Province, China
| | - Qingqing Feng
- Qingdao Center Hospital, the Second Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, China
| | - Wenzhi Ding
- Qingdao Eye Hospital, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, 266071, Shandong Province, China
| | - Yusu Peng
- Qingdao Eye Hospital, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, 266071, Shandong Province, China
| | - Keli Long
- Qingdao Eye Hospital, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, 266071, Shandong Province, China.
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Gadde AK, Srirampur A, Katta KR, Mansoori T, Armah SM. Comparison of single-step transepithelial photorefractive keratectomy and conventional photorefractive keratectomy in low to high myopic eyes. Indian J Ophthalmol 2020; 68:755-761. [PMID: 32317441 PMCID: PMC7350485 DOI: 10.4103/ijo.ijo_1126_19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Purpose To compare the visual outcome, safety, safety index, efficacy, efficacy index and corneal transparency between single-step transepithelial photorefractive keratectomy (t-PRK) and conventional photorefractive keratectomy (PRK) with manual debridement of epithelium in eyes with low to high simple myopia and compound myopic astigmatism. Methods In this retrospective ,case control study, we analysed and compared the postoperative uncorrected visual acuity(UCVA), postoperative best corrected visual acuity (BCVA) , safety, safety index,efficacy,efficacy index and the corneal transparency between t-PRK and PRK with 6th-generation Amaris excimer 500E laser (Schwind eye-tech-solutions) in 115 eyes of 59 patients. Results Preoperative Mean Refractive Spherical Equivalent (MRSE) was - 3.88 + 0.23 Diopters(D) and -4.73 + 0.23D in PRK and t-PRK group respectively(p=0.09). In both the groups , none of the eyes lost postoperative BCVA at the end of mean follow-up period of 3.5 months . All the eyes achieved post operative UCVA of 20/40 or better in both the groups. Incidence of trace corneal haze was high in t-PRK group at the end of 3.5 months (P = 0.003). Conclusion Single-step t-PRK and PRK provide similar results at the end of mean follow-up period of 3.5 months postoperatively with regards to post-operative UCVA, post operative BCVA, safety, safety index, efficacy and efficacy index. There was high incidence of trace haze in t- PRK eyes. Both the procedures are predictable, effective, and safe for correction of low to high myopia.
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Affiliation(s)
- Aruna Kumari Gadde
- Department of Cataract and Refractive Services, Anand Eye Institute, Hyderabad, Telangana, India
| | - Arjun Srirampur
- Department of Cataract and Refractive Services, Anand Eye Institute, Hyderabad, Telangana, India
| | - Kavya Reddy Katta
- Department of Cataract and Refractive Services, Anand Eye Institute, Hyderabad, Telangana, India
| | - Tarannum Mansoori
- Department of Glaucoma Services, Anand Eye Institute, Hyderabad, Telangana, India
| | - Seth Mensah Armah
- Department of Nutrition, University of North Carolina at Greensboro, Greensboro, North Carolina, USA
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Rodriguez AH, Galvis V, Tello A, Parra MM, Rojas MÁ, Arba MS, Camacho AP. Fellow eye comparison between alcohol-assisted and single-step transepithelial photorefractive keratectomy: late mid-term outcomes. Rom J Ophthalmol 2020; 64:176-183. [PMID: 32685784 PMCID: PMC7339690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective: To compare late mid-term results of two different surgical approaches of surface excimer laser ablation for myopic and astigmatic errors in contralateral eyes of the same patients. Methods: Prospective cohort study. A photorefractive keratectomy technique was performed on the right eye and single-step transepithelial photorefractive keratectomy on the left eye of the same patient, in 2012. Postoperative uncorrected and corrected visual acuities, manifest refraction, contrast sensitivity, objective scatter index, tear film stability assessed by serial measurements of objective scatter index and aberrometry as well as occurrence of haze, were compared between groups of eyes. Results: Thirty-two eyes of 16 patients with a mean time of follow-up of 35.2 +/ - 5.0 months (range 30-46 months) were evaluated. No significant differences were observed in postoperative results (visual acuity, spherical equivalent, defocus equivalent, higher-order aberrations, objective scatter index, tear film stability and contrast sensitivity). Contrast sensitivity tended to be better in transepithelial photorefractive keratectomy technique, under photopic lighting conditions without glare and mesopic conditions both with glare and without glare, however, no statistically significant differences were found. No eye presented corneal haze at the last examination. Conclusion: No statistically significant differences in visual acuity, refractive results, contrast sensitivity, objective scatter index, tear film stability or ocular aberrometry were observed between the two surface ablation techniques.
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Affiliation(s)
- Alexander Harold Rodriguez
- Ophthalmology Department, Universidad Industrial de Santander UIS,
Bucaramanga, Colombia
,Ophthalmology Department, Fundación Oftalmológica de Santander FOSCAL,
Floridablanca, Colombia
| | - Virgilio Galvis
- Ophthalmology Department, Fundación Oftalmológica de Santander FOSCAL,
Floridablanca, Colombia
,Centro Oftalmológico Virgilio Galvis, Floridablanca, Colombia
,Ophthalmology Department, Universidad Autónoma de Bucaramanga UNAB,
Floridablanca, Colombia
| | - Alejandro Tello
- Ophthalmology Department, Fundación Oftalmológica de Santander FOSCAL,
Floridablanca, Colombia
,Centro Oftalmológico Virgilio Galvis, Floridablanca, Colombia
,Ophthalmology Department, Universidad Autónoma de Bucaramanga UNAB,
Floridablanca, Colombia
| | - Margarita María Parra
- Ophthalmology Department, Universidad Industrial de Santander UIS,
Bucaramanga, Colombia
,Ophthalmology Department, Fundación Oftalmológica de Santander FOSCAL,
Floridablanca, Colombia
| | | | - Mosquera Samuel Arba
- Biomedical Engineering Office, Research and Development, SCHWIND eye-tech-solutions GmbH, Kleinostheim, Germany
| | - Anthony Paul Camacho
- Ophthalmology Department, Fundación Oftalmológica de Santander FOSCAL,
Floridablanca, Colombia
,Centro Oftalmológico Virgilio Galvis, Floridablanca, Colombia
,Ophthalmology Department, Universidad Autónoma de Bucaramanga UNAB,
Floridablanca, Colombia
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Goggin M, Stewart P, Andersons V, Criscenti G. Fine tuning of the default depth and rate of ablation of the epithelium in customized trans-epithelial one-step superficial refractive excimer laser ablation. EYE AND VISION 2019; 6:39. [PMID: 31828176 PMCID: PMC6889590 DOI: 10.1186/s40662-019-0159-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 10/14/2019] [Indexed: 11/17/2022]
Abstract
Purpose To fine tune the default depth and rate of ablation of the epithelium in cTen™ customized trans-epithelial one-step superficial refractive surgery by the comparison between the attempted post-operative ideal corneal shape and the achieved corneal shape. Methods 88 consecutive eyes in 64 patients undergoing trans-epithelial superficial excimer ablation using the iVis laser Suite for either myopic/astigmatic or hyperopic/astigmatic refractive error. Each patient had at least 3 months of post-operative follow-up. Topographic examination of all eyes was carried out pre-operatively and at least 3 months post-operatively using the Precisio™ surgical topographer. The comparison of these two measurements yielded values for depth, volumes and rates of ablated corneal tissue. By determining the different ablation rates of stroma and epithelium, a refinement of the depth of epithelium to be removed and a refinement of the stromal ablation were calculated. The mathematical model was applied on each one of the 88 clinical cases and the parameters for the fine tuning of the default depth and rate of ablation of the epithelium were determined using the least squares method. Results The calculated pure stromal ablation rate was less than the average epithelium/stroma ablation rate used in planning the treatments by a factor of 0.96. The epithelial thickness predefined ablation assumption used to plan removal of the epithelium was adjusted considering the measured ablation and a radial adjustment function established for the fine tuning of the laser radial efficiency and allowing for the normal thickening of the epithelium in the peripheral cornea. From a clinical point of view, this methodology produces an improvement of the efficacy and a reduction of the variance of the clinical results. Conclusion Comparison of accurately measured pre and postoperative topographies yields accurately established ablation rates of stroma and epithelium in trans-epithelial one step superficial ablation.
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Affiliation(s)
- Michael Goggin
- 1South Australian Institute of Ophthalmology, University of Adelaide, Adelaide, Australia
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Comparison between Transepithelial Photorefractive Keratectomy versus Alcohol-Assisted Photorefractive Keratectomy in Correction of Myopia and Myopic Astigmatism. J Ophthalmol 2018; 2018:5376235. [PMID: 30538854 PMCID: PMC6260527 DOI: 10.1155/2018/5376235] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 09/27/2018] [Accepted: 10/15/2018] [Indexed: 11/18/2022] Open
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.
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Z-LASIK and Trans-PRK for correction of high-grade myopia: safety, efficacy, predictability and clinical outcomes. Int Ophthalmol 2018. [DOI: 10.1007/s10792-018-0868-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Adib-Moghaddam S, Soleyman-Jahi S, Adili-Aghdam F, Arba Mosquera S, Hoorshad N, Tofighi S. Single-step transepithelial photorefractive keratectomy in high myopia: qualitative and quantitative visual functions. Int J Ophthalmol 2017; 10:445-452. [PMID: 28393038 DOI: 10.18240/ijo.2017.03.19] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Accepted: 10/08/2016] [Indexed: 11/23/2022] Open
Abstract
AIM To investigate quantitative and qualitative optical outcomes of single-step transepithelial photorefractive keratectomy (TransPRK) in high myopia. METHODS In a prospective interventional case-series, 30 eyes with high myopia (-6.00 to -8.75 D) with (up to -3.00 D) or without astigmatism were enrolled from Bina Eye Hospital, Tehran, Iran. One-step TransPRK was performed with aberration-free aspherical optimized profile and SCHWIND AMARIS 500 laser. One-year follow-up results for refraction, visual acuities, vector analysis, ocular wave-front (OWF) and corneal wave-front (CWF) higher order aberrations (HOA), contrast sensitivity (CS), and post-operative haze were assessed. RESULTS After the surgery, both photopic and mesopic CSs significantly improved (both P<0.001). We detected significant induction of OWF coma and trefoil (P<0.001 for both) HOAs; CWF coma (P=0.002), spherical (P<0.001), and tetrafoil (P=0.003) HOAs in 6 mm analysis diameter; and CWF trefoil (P=0.04) HOA in 4 mm analysis diameter. The range of mean induction observed for various HOAs was 0.005-0.11 µm. The 86.7% of eyes reached an uncorrected distance visual acuity of 20/20 or better; 96.7% of eyes were within ±0.5 D of targeted spherical refraction. In vector analysis, mean correction index value was 1.03 and mean index of success was 0.22. By 12mo after the operation, no eye lost any number of corrected distance visual acuity lines. We detected no corneal haze greater than 1+ throughout the follow-up. CONCLUSION Our findings show promising effects of single-step TransPRK on quality of vision in high myopic eyes. It also improves refraction and visual acuity.
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Affiliation(s)
- Soheil Adib-Moghaddam
- Bina Eye Hospital, Tehran 1634764651, Iran; TransPRK Research Group, Tehran 1586863813, Iran; Universal Council of Ophthalmology (UCO), Universal Scientific Education and Research Network (USERN), Tehran 1417613151, Iran
| | - Saeed Soleyman-Jahi
- Bina Eye Hospital, Tehran 1634764651, Iran; TransPRK Research Group, Tehran 1586863813, Iran; Universal Council of Ophthalmology (UCO), Universal Scientific Education and Research Network (USERN), Tehran 1417613151, Iran
| | - Fatemeh Adili-Aghdam
- Bina Eye Hospital, Tehran 1634764651, Iran; TransPRK Research Group, Tehran 1586863813, Iran; Universal Council of Ophthalmology (UCO), Universal Scientific Education and Research Network (USERN), Tehran 1417613151, Iran
| | - Samuel Arba Mosquera
- Universal Council of Ophthalmology (UCO), Universal Scientific Education and Research Network (USERN), Tehran 1417613151, Iran; SCHWIND Eye-Tech-Solutions, Kleinostheim D-63797, Germany; Instituto de Oftalmobiología Aplicada, University of Valladolid, Valladolid 8-47002, Spain
| | - Niloofar Hoorshad
- Bina Eye Hospital, Tehran 1634764651, Iran; TransPRK Research Group, Tehran 1586863813, Iran; Universal Council of Ophthalmology (UCO), Universal Scientific Education and Research Network (USERN), Tehran 1417613151, Iran
| | - Salar Tofighi
- Bina Eye Hospital, Tehran 1634764651, Iran; TransPRK Research Group, Tehran 1586863813, Iran; Universal Council of Ophthalmology (UCO), Universal Scientific Education and Research Network (USERN), Tehran 1417613151, Iran
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Tomás-Juan J, Murueta-Goyena Larrañaga A, Hanneken L. Corneal Regeneration After Photorefractive Keratectomy: A Review. JOURNAL OF OPTOMETRY 2015; 8:149-69. [PMID: 25444646 PMCID: PMC4502084 DOI: 10.1016/j.optom.2014.09.001] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2014] [Revised: 08/01/2014] [Indexed: 05/20/2023]
Abstract
Photorefractive keratectomy (PRK) remodels corneal stroma to compensate refractive errors. The removal of epithelium and the ablation of stroma provoke the disruption of corneal nerves and a release of several peptides from tears, epithelium, stroma and nerves. A myriad of cytokines, growth factors, and matrix metalloproteases participate in the process of corneal wound healing. Their balance will determine if reepithelization and stromal remodeling are appropriate. The final aim is to achieve corneal transparency for restoring corneal function, and a proper visual quality. Therefore, wound-healing response is critical for a successful refractive surgery. Our goal is to provide an overview into how corneal wounding develops following PRK. We will also review the influence of intraoperative application of mitomycin C, bandage contact lenses, anti-inflammatory and other drugs in preventing corneal haze and post-PRK pain.
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Affiliation(s)
- Javier Tomás-Juan
- Department of Visual Science, VallmedicVision International Eye Clinic, Andorra.
| | | | - Ludger Hanneken
- Department of Visual Science, VallmedicVision International Eye Clinic, Andorra
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