Efficacy and safety of transepithelial photorefractive keratectomy.

J Cataract Refract Surg

From the Bina Eye Hospital (Adib-Moghaddam, Soleyman-Jahi, Hoorshad, Tefagh, Haydar, Razi-Khoshroshahi), TransPRK Research Group (Adib-Moghaddam, Soleyman-Jahi, Sanjari-Moghaddam, Hoorshad, Tefagh, Haydar, Razi-Khoshroshahi), Universal Council of Ophthalmology, Universal Scientific Education and Research Network (Adib-Moghaddam, Soleyman-Jahi, Sanjari-Moghaddam, Hoorshad, Tefagh, Haydar, Razi-Khoshroshahi, Arba Mosquera), and School of Medicine, Shahid Beheshti University of Medical Sciences (Sanjari-Moghaddam), Tehran, Iran; Schwind Eye-Tech-Solutions (Arba Mosquera), Kleinostheim, Germany; University of Valladolid (Arba Mosquera), Valladolid, Spain.

Published: October 2018

Transepithelial photorefractive keratectomy (PRK) was introduced to prevent complications from conventional PRK and femtosecond laser-assisted laser in situ keratomileusis (LASIK). In the 2-step platform, phototherapeutic keratectomy is followed by PRK. It did not show notable safety or efficacy superiorities over conventional PRK. In the conventional single-step transepithelial PRK, ablation of epithelium and stroma occurs in a single continuous session by an Amaris laser. It showed better comparative safety results. Reverse single-step transepithelial PRK and the platform using smart-pulse technology were recent improvements in the single-step Amaris laser. They provide a smoother postablative stromal bed counter. In the refined single-step platform, a modified nomogram is used for determination of ablation parameters, along with modifications in postablative measures. It yielded better comparative results in hyperopia. Controlled trials comparing reverse, smart-pulse technology-equipped, or refined platforms of single-step transepithelial PRK with other modern laser-assisted methods could provide more robust evidence on the topic. Some key elements with significant roles in post-transepithelial PRK outcomes are discussed.

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http://dx.doi.org/10.1016/j.jcrs.2018.07.021DOI Listing

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