Two-Step Transepithelial Photorefractive Keratectomy with WaveLight EX500 Platform for Adolescents and Adults with Low to Moderate Myopia: A 12-Month Comparative Evaluation

Abstract

Purpose: To compare the visual and refractive results obtained after two-step TransPRK using an EX500 excimer laser for low to moderate myopic correction in adolescents and adults. Patients and Methods: Retrospectively, 91 eyes of 52 patients were categorized into four groups based on age and level of myopia. The demographics, data of efficacy, safety, predictability, stability, and post-operative complications were evaluated at 1, 3, 6, and 12 months post-operatively. Results: At 1-month, adolescents with low myopia achieved the highest mean efficacy index (P =0.034). The efficacy indices continuously increased during the 1-year follow-up in all groups, except in adolescents with moderate myopia. The highest safety and efficacy indices were recorded in adolescents with low myopia at 1-year. Post-operative spherical equivalent within ±0.50 D at 1 year was 48.75% of all treated eyes; however, the final mean refractive spherical equivalent (MRSE) was under-corrected in all groups. By month 3, the percentage of eyes that had grade 0.5 haze was most prevalent in adolescents with moderate myopia (P <0.001). Conclusion: two-step TransPRK using an EX500 proved to be an effective, predictable, stable and safe procedure for the correction of low to moderate myopia with or without astigmatism at 1 year. Adolescents with low myopia achieved the best-post-operative UDVA, efficacy and safety indices. Adolescents tolerated night visual problems and dry eye symptoms better than adults.

Refractive results of photorefractive keratectomy comparing trans-PRK and PTK−PRK for correction of myopia and myopic astigmatism

“…On the one hand, the t PRK method has been proven many times as a safe and effective way to treat myopia [ 7 ]. On the other hand, the PTK−PRK procedure seems to show stable results, as demonstrated previously by two groups [ 8 , 9 ] with the EX500 laser (Alcon Laboratories). Also, older publications indicate that the PTK−PRK combination is an effective treatment [ 10 , 11 ].…”

“…This is the first study comparing the t PRK technique using the Amaris750 with PTK−PRK performed with MEL90. Tangmonkongvoragul et al demonstrated good refractive results of the PTK−PRK method for treating mild myopia with the EX500 excimer laser [ 8 ]. A recently published study also confirmed the efficacy of PTK−PRK surgery compared to t PRK treatment [ 9 ].…”

Visual outcomes and recurrence rate of macular corneal dystrophy following phototherapeutic keratectomy in Saudi Arabia

“…Transepithelial photorefractive keratectomy (PRK) is safe and effective for treating low-to-moderate myopia, and compared with alcohol-assisted PRK, it is associated with less postoperative pain, faster reepithelialization and visual recovery, less tissue removal, less haze, and shorter surgical times. [ 20 , 21 ] Another advantage of transepithelial PTK in treating surface irregularities is that the epithelium works as a natural masking agent which enhances the outcomes of surface smoothing following PTK. [ 22 ] In our study, around 74% of eyes ( n = 31) underwent transepithelial PTK, all 31 eyes had timely healing of epithelial defects with no delay.…”