Prognostic factors of visual quality after transepithelial photorefractive keratectomy in patients with low-to-moderate myopia.

Purpose: The aim of this study was to evaluate visual quality after high-frequency transepithelial photorefractive keratectomy (t-PRK) by assessing the relationship between the operational parameters and the first-year postoperative corneal higher-order aberrations (HOAs).

Methods: This was a retrospective study of low-to-moderate myopic eyes treated with t-PRK. The files of 46 low-to-moderate myopic patients (90 eyes; myopia up to -5D) were included in the study. Eyes having a cylindrical refractive error more than 2D and the patients not having completed a 1-year follow-up were excluded from the study. Factors including age, preoperative mean spherical equivalent (MSE), mean keratometry (Km), central corneal thickness (CCT), scotopic pupil, optical zone (OZ), transition zone (TZ), ablation zone (AZ), central ablation depth (CAD), and static cyclotorsion correction (SCC) were analyzed for association with the first-year postoperative corneal HOAs.

Results: Corneal HOAs were found to be increased postoperatively with a 6-mm pupil (P < 0.05). The increased spherical aberration had a positive correlation with patient age, preoperative MSE, Km, TZ, and CAD, whereas it had a negative relationship with OZ and AZ (P < 0.05). The corneal coma had a significantly positive correlation with preoperative MSE and a significantly negative relationship with OZ (P < .05).

Conclusion: Postoperatively induced corneal HOAs may affect patients' scotopic vision (night time driving, cinema) when the pupils get larger. The relationship between patient age, preoperative MSE, Km, CAD, TZ, OZ, AZ, and postoperative corneal HOAs underlines the need to consider the effects of these parameters on the final vision quality.