Purpose: To compare the outcomes and complications of Epi-Bowman blunt keratectomy (EBK) using a blunt epikeratome (Epi-Clear, Orca Surgical, Israel), with alcohol delamination of the corneal epithelium during photorefractive keratectomy (PRK) in contralateral eyes.

Methods: This prospective, randomized contralateral eye study included 44 eyes of 22 patients undergoing PRK for bilateral myopia or myopic astigmatism. In each patient, epithelial delimitation was performed using an Epi-Clear epikeratome EBK (EBK group) on 1 eye and diluted ethanol (EtOH) on the fellow eye (EtOH group). Postoperative pain, epithelial healing, epithelial profile, and visual outcome were compared between the 2 groups.

Results: The mean postoperative pain scores were 0.37 ± 0.25 for the EBK group and 0.82 ± 0.22 for the EtOH group (P = 0.043). The mean epithelial defect size at day 3 postoperatively was 1.61 ± 1.46 and 2.25 ± 1.69 mm, respectively (P = 0.034). The postoperative 3-month remaining mean spherical equivalent was 0.04 ± 0.49 diopters for the EBK group and 0.21 ± 0.26 D for the EtOH group (P = 0.520). There was no significant difference in UCVA and BCVA between the groups.

Conclusions: Our data suggest that this novel EBK device and technique may minimize postoperative pain, accelerate re-epithelialization, and offer earlier visual recovery, compared with EtOH when used for myopic PRK.

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