Transepithelial Photorefractive Keratectomy for Hyperopia Correction: An Uncharted Territory

Abstract

Transepithelial photorefractive keratectomy (Trans PRK) is a relatively new technology for refractive surgery and has shown promising results in myopia correction. The data on hyperopia correction by this method are limited. In this review, we have attempted to understand the outcomes of this technology on hyperopic eyes. There are comparable results with conventional PRK and laser in situ keratomileusis (LASIK) as far as refractive stability, regression rate, predictability, and post-operative complications are concerned. The best results have been obtained in lower hyperopic corrections. In moderate to higher hyperopia, the limited data available show higher regression, unstable visual outcomes, and increased stromal haze. There is a need to evaluate the technology further to understand its success for hyperopic refractive surgery.

Advances in Transepithelial Photorefractive Keratectomy versus Laser-Assisted In Situ Keratomileusis

“…On one hand, Trans-PRK was reported to provide better or comparable results for myopic patients [ 12 , 13 ] and could provide a lower increase in corneal higher order aberrations versus FS-LASIK [ 14 ]. However, other studies suggest more caution, with Gershoni A. et al [ 15 ] reporting better result with FS-LASIK for low–moderate-grade myopia and Sabhapandit S. et al [ 16 ] highlighting hyperopia as an uncharted territory for Trans-PRK [ 16 ]. In this study, despite the initial differences in the study population for Trans-PRK and FS-LASIK leading towards a myopic population for Trans-PRK and a slightly hyperopic one for FS-LASIK (Ablative target in spherical diopters (Trans-PRK −2.722 ± 2.696 versus FS-LASIK +0.944 ± 3.668 D; p < 0.001), ablative target in cylinder diopters (Trans-PRK −1.178 ± 1.557 versus FS-LASIK +0.214 ± 2.886 D; p = 0.001) and attempted spherical equivalent (Trans-PRK −3.311 ± 2.69 versus FS-LASIK +1.052 ± 4.109 D; p = 0.001), the early postoperative results at 1 week and 1 month did not present notable statistical differences.…”