Epithelial healing and clinical outcome in excimer laer photorefractive urgery following three epithelial removal technique: Mechanical, alcohol, and excimer laer

Purpoe To evaluate epithelial healing, potoperative pain, and viual and refractive outcome after photorefractive keratectomy (PRK) uing three epithelial removal technique. Deign Propective, nonrandomized, comparative trial. Method etting: Department of Ophthalmology, Yonei Univerity College of Medicine and Balgeneang Ophthalmology Clinic, eoul, Korea. intervention: For the PRK procedure, the corneal epithelium wa removed in one of three way: mechanically (conventional PRK [PRK]) in 88 eye of 44 patient; uing excimer laer (tranepithelial PRK [tPRK]) in 106 eye of 53 patient; or uing 20% diluted alcohol, laer-aited ubepithelial keratomileui (LAEK) in 106 eye of 53 patient. main outcome meaure: Epithelial healing, potoperative pain, uncorrected viual acuity (UCVA), bet pectacle-corrected viual acuity (BCVA), and remaining refractive error. Reult The mean potoperative pain core were 4.84 ± 1.45 for PRK, 4.71 ± 1.62 for tPRK, and 4.63 ± 1.52 for LAEK (P = .125). The mean epithelial healing rate were 12.3 ± 4.6 for PRK, 15.2 ± 4.9 for tPRK, and 18.1 ± 5.2 mm2/day for LAEK (P < .001). The potoperative 6-month remaining mean pherical equivalent (diopter) were −0.46 ± 1.01 for PRK, 0.18 ± 0.91 for tPRK, and −0.82 ± 1.18 for LAEK (P = .01). The LAEK group howed le favorable UCVA than other group. There wa no ignificant difference in BCVA between the group. Concluion Potoperative pain, ubepithelial opacity and BCVA were imilar regardle of the epithelial removal procedure. A fater epithelial healing rate did not reult in better viual or refractive outcome. Uing the ame nomogram, tPRK reulted in a light overcorrection, and LAEK reulted in a light undercorrection.