Comparison of clinical results between trans-PRK and femtosecond LASIK for correction of high myopia

Zhang, Jiafan; Feng, Qingqing; Ding, Wenzhi; Peng, Yusu; Long, Keli

doi:10.1186/s12886-020-01515-9

Cited by 22 publications

(24 citation statements)

References 28 publications

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“…Our case series resembled the other TransPRK cohorts in terms of preoperative myopia and postoperative UCVA and efficacy and safety indices. Our predictability index (96%) tended to be higher than those of the other TransPRK cohorts (59–87%), possibly because refraction stabilizes at 6–12 months; our study duration was 6 months whereas the studies that reported predictability had durations of 12 months [ 25 , 26 , 28 – 30 , 34 ]. Our low rate of clinically significant haze was also observed by six of the studies (0–1% of patients had Fantes grade ≥2 at the end of follow-up).…”

Section: Discussioncontrasting

confidence: 54%

“…Similarly, Zhang et al . reported using cold balanced salt solution after laser ablation [ 25 ]. Two, non mutually exclusive, hypotheses can explain the lack of haze after TransPRK in high myopia without mitomycin-C. First, applying cooled physiological fluids before/after the procedure may reduce the increased corneal temperature caused by the thermal effect of excimer laser ablation [ 39 ].…”

Section: Discussionmentioning

confidence: 99%

“…A recent prospective cohort study by Zhang et al . also suggests that mitomycin-C may also not be needed after ASLA SCHWIND TransPRK for high myopia: they showed that at 12 months, eyes that were treated with TransPRK without mitomycin-C were comparable to LASIK-treated eyes in terms of efficacy and safety and significantly better in terms of residual myopia and predictability; importantly, none of the TransPRK-treated eyes had more than trace haze at the last follow-up [ 25 ].…”

Section: Introductionmentioning

confidence: 99%

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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

et al. 2021

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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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Section: Discussioncontrasting

confidence: 54%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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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

et al. 2021

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“…These results were consistent with our report. A recent study [ 20 ] followed up for 12 months to compare the changes of corneal HOAs between Trans-PRK and FS-LASIK for high myopia, and found that corneal HOAs and vertical coma in the Trans-PRK group were statistically significantly lower than those in the FS-LASIK group, while the horizontal coma and spherical aberration of the cornea were similar between the two groups. We believe that diopter difference may be the reason for the difference between the results of this study and those of theirs.…”

Section: Discussionmentioning

confidence: 99%

Corneal Asphericity and Higher-Order Aberrations after FS-LASIK and Trans-PRK for Myopia

Wang

et al. 2021

Journal of Ophthalmology

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Objective. To compare the corneal asphericity and higher-order aberrations (HOAs) of femtosecond laser-assisted in situ keratomileusis (FS-LASIK) with Smart Pulse Technology (SPT) assisted transepithelial photorefractive keratectomy (Trans-PRK) for myopia and myopic astigmatism correction. Methods. This prospective study analyzed 88 eyes of 44 patients treated with FS-LASIK and 64 eyes of 32 patients treated with Trans-PRK. All eyes had low to moderate myopia with or without astigmatism (spherical equivalent (SE) <−6.00 diopters). The uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), SE, asphericity (Q value) of the anterior corneal surface, index of surface variance (ISV), corneal higher-order aberrations (HOAs), vertical coma (Z3−1), horizontal coma (Z31), and spherical aberration (Z40) over a 6 mm diameter central corneal zone diameter were evaluated preoperatively and 1, 3, and 6 months postoperatively. Results. At 6 months, the UDVA and SE were −0.14 ± 0.06 and 0.33 ± 0.33D in FS-LASIK and −0.15 ± 0.06 and 0.35 ± 0.37D in Trans-PRK. There was no difference between the two groups in the postoperative UDVA and SE ( P > 0.05 ). After FS-LASIK and Trans-PRK, the Q values in the 6, 7, 8, and 9 mm zones and ISV of the anterior corneal surface significantly increased ( P < 0.001 ). At 1, 3, and 6 months after surgery, corneal HOA, Z3-1, Z31, and Z40 in both groups were significantly increased compared with those before surgery, with statistically significant differences ( P < 0.001 ). At 1, 3, and 6 months after surgery, the Z3−1 of the Trans-PRK group was significantly lower than that of the FS-LASIK group ( P < 0.001 ). ΔHOA and ΔZ40 were dramatically correlated with the ΔQ value for both FS-LASIK and Trans-PRK procedures. The ΔQ was significantly correlated with the preoperative SE, AD, and AD/CCT after both two procedures (all P < 0.001 ). Conclusions. Both FS-LASIK and Trans-PRK caused the anterior corneal surface to become flatter, and the morphology of the corneal surface was irregular. Corneal HOAs were significantly increased after the two procedures. Trans-PRK using SPT introduced less corneal vertical coma than FS-LASIK. Corneal asphericity changes contributed to the corneal aberrations changes following FS-LASIK and Trans-PRK.

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“…LASIK had a slightly better efficacy, predictability, and lower enhancement rate, 28 while haze was still a problem in PRK for myopia > 10 D. 21 Recent PRK outcomes have been excellent for high myopic (>6 D) correction compared to femtosecond laser-assisted LASIK (F-LASIK). 29,30 Moreover, PRK induced less HOA than F-LASIK. 30,31 Compared to our previous study on F-LASIK outcomes with the same excimer laser machine and treatment profile (WFO), the efficacy of PRK in this present study for both treatment groups are slightly better than those of F-LASIK.…”

Section: Discussionmentioning

confidence: 95%

Twelve-Month Outcomes of the Wavefront-Optimized Photorefractive Keratectomy for High Myopic Correction Compared with Low-to-Moderate Myopia

Tananuvat¹,

Winaikosol²,

Niparugs³

et al. 2021

OPTH

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Purpose: To evaluate the 12-months outcomes of photorefractive keratectomy (PRK) in patients with high myopia (≥ 6.0 diopters, D) compared with low-to-moderate myopia (< 6.0 D). Patients and Methods: Records of 46 patients (69 eyes) who underwent PRK for myopic and astigmatic correction between October 2015 and December 2018 were reviewed. High myopic eyes (29 eyes) were compared with low-to-moderate myopic eyes (40 eyes). All surgeries were adjunct with 0.02% mitomycin C intraoperatively. Measured outcomes included postoperative uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refraction spherical equivalent, corneal haze rate, and any complications. Results: At 12 months post-PRK, 26 eyes (89.7%) in the high myopia and 39 eyes (97.5%) in the low-to-moderate myopia group had UDVA ≥ 20/20, (p=0.30). Average postoperative logMAR UDVA at 12 months was −0.04 (20/18) and −0.11 (20/15) for the high myopia and low-to-moderate myopia groups, respectively. No eyes in either group had residual refractive errors >1 D. No eyes in both groups developed significant corneal haze at month 12. No eyes had a loss of greater than two Snellen lines of CDVA at 12 months post-surgery. The efficacy and safety indices at 12 months post-surgery were not significantly different between groups (1.06±0.26 vs.1.14±0.27, p =0.25 and 1.14±0.27 vs 1.17±0.26, p=0.60 for low-to-moderate myopia vs high myopia groups, respectively). Conclusion: PRK with high myopic correction provides excellent refractive outcomes and is safe, compared to those of low-to-moderate myopic correction.

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Comparison of clinical results between trans-PRK and femtosecond LASIK for correction of high myopia

Cited by 22 publications

References 28 publications

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

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

Corneal Asphericity and Higher-Order Aberrations after FS-LASIK and Trans-PRK for Myopia

Twelve-Month Outcomes of the Wavefront-Optimized Photorefractive Keratectomy for High Myopic Correction Compared with Low-to-Moderate Myopia

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