Purpose: To compare the outcomes and complications of alcohol-assisted versus mechanical corneal epithelial debridement for photorefractive keratectomy (PRK).
Methods: This randomized controlled trial included 1,250 eyes of 625 patients undergoing PRK for correction of myopia and myopic astigmatism. Each patient was randomly assigned to alcohol-assisted or mechanical epithelial removal.
Results: A total of 658 eyes underwent alcohol-assisted epithelial removal while the epithelium was removed mechanically in 592 eyes. Mean spherical equivalent was -4.37±2.3 D in the alcohol group and -3.8±1.3 D in the mechanical group (P = 0.78). There was no significant difference in postoperative pain between the study groups (P = 0.22). Uncorrected visual acuity ≥ 20/20 and ≥ 20/40 was achieved in 90.9% versus 93.4% (P = 0.08), and 98.9% versus 99.5% (P = 0.36) of eyes in the alcohol and mechanical groups, respectively. Final refractive error within 1D of emmetropia was achieved in 90% versus 92.2% of eyes in the alcohol and mechanical groups, respectively (P = 0.23). Alcohol-assisted debridement required less time than mechanical debridement (96±18 vs. 118±26 seconds, P=0.035). There was no significant difference between the two groups in terms of early and late postoperative complications.
Conclusion: Alcohol-assisted and mechanical epithelium removal are comparable in terms of efficacy and side effects. The method of epithelial debridement in PRK may be left to the surgeon's choice.
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Article Synopsis
- - Photorefractive keratectomy (PRK) is the original excimer laser procedure for treating refractive errors, proving to be safe and widely performed worldwide despite the rise of newer methods like LASIK and KLEx.
- - Although many surgeons prefer LASIK for its quicker recovery and comfort, PRK is still a strong option for many candidates and is particularly suitable in specific situations.
- - This review discusses various PRK techniques, compares refractive outcomes with other laser procedures, and examines the corneal healing responses, benefits, and complications associated with PRK to help surgeons make informed decisions.
Comparison of objective and subjective visual quality after flapless laser vision correction for mild to moderate myopia: SMILE vs PRK.
Graefes Arch Clin Exp Ophthalmol
June 2023
Department of Ophthalmology, Peking University Third Hospital, No 49 Huayuan North Road, Haidian District, Beijing, 100191, China.
Purpose: To investigate the differences in surgical results and the objective and subjective quality of vision (QoV) of patients after small incision lenticule extraction (SMILE) versus alcohol-assisted photorefractive keratectomy (PRK).
Methods: Medical records of patients treated with SMILE and PRK were retrospectively examined. Visual quality, biometric parameters, Strehl ratio (SR), and corneal higher-order aberrations (HOAs) within a 6.
Comparison of transepithelial and conventional photorefractive keratectomy in myopic and myopic astigmatism patients: a randomized contralateral trial.
BMC Ophthalmol
February 2022
Noor Ophthalmology Research Center, Noor Eye Hospital, 96, Esfandiar Blvd, Valiasr St, Tehran, Tehran, 1968653111, Iran.
Background: To assess transepithelial photorefractive keratectomy (tPRK) in terms of corneal epithelial healing rate, postoperative pain, postoperative discomfort, and visual and refraction outcomes compared to mechanical epithelial debridement PRK (mPRK) and alcohol-assisted PRK (aaPRK).
Methods: In this double-masked, randomized clinical trial, thirty-nine patients underwent tPRK in one eye and mPRK in the fellow eye (arm A), and 33 patients underwent tPRK in one eye and aaPRK in the contralateral eye (arm B). All surgical procedures were done using the Schwind Amaris excimer laser.
Comparison of Postoperative Symptoms of Alcohol-Assisted Versus Mechanical Epithelial Removal in Photorefractive Keratectomy: A Contralateral Double Blind Clinical Trial.
Eye Contact Lens
December 2021
Translational Ophthalmology Research Center (M.M., F.R., M.H., M.K.-N.), Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran; and School of Rehabilitation (M.K.-N.), Tehran University of Medical Sciences, Tehran, Iran.
Purpose: To compare the short-term complaints of postoperative pain, and other ocular discomfort symptoms in patients who underwent photorefractive keratectomy (PRK) with alcohol-assisted epithelial removal in one eye versus mechanical debridement in the other eye.
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Epi-Bowman keratectomy versus alcohol-assisted photorefractive keratectomy: wound healing and complications.
Ther Adv Ophthalmol
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University Eye Hospital, Ruhr-University Bochum, Bochum, Germany.
Purpose: In Epi-Bowman Keratectomy™ (EBK), a new dynamic multi-blade single-use device (Epi-Clear™, Orca Surgical, Israel) is utilized to remove the epithelium by sweeping movements across the corneal surface. Epithelial cells are discarded. Alcohol or other chemical agents are not utilized.
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