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Concept: Photorefractive keratectomy

148

Transepithelial photorefractive keratectomy (tPRK), where both the epithelium and stroma are removed in a single-step, is a relatively new procedure of laser refractive error correction. This study compares the 3-month results of myopia and compound myopic astigmatism correction by tPRK or conventional alcohol-assisted PRK (aaPRK).This prospective, nonrandomized, case-control study recruited 148 consecutive patients; 93 underwent tPRK (173 eyes) and 55 aaPRK (103 eyes). Refractive results, predictability, safety, and efficacy were evaluated during the 3-month follow-up. The main outcome measures were uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and mean refractive spherical equivalent (MRSE).Mean preoperative MRSE was -4.30 ± 1.72 D and -4.33 ± 1.96 D, respectively (P = 0.87). The 3-month follow-up rate was 82.1% in the tPRK group (n = 145) and 86.4% in aaPRK group (n = 90), P = 0.81. Postoperative UDVA was 20/20 or better in 97% and 94% of eyes, respectively (P = 0.45). In the tPRK and aaPRK groups, respectively, 13% and 21% of eyes lost 1 line of CDVA, and 30% and 31% gained 1 or 2 lines (P = 0.48). Mean postoperative MRSE was -0.14 ± 0.26 D in the tPRK group and -0.12 ± 0.20 D in the aaPRK group (P = 0.9). The correlation between attempted versus achieved MRSE was equally high in both groups.Single-step transepithelial PRK and conventional PRK provide very similar results 3 months postoperatively. These procedures are predictable, effective, and safe for correction of myopia and compound myopic astigmatism.

Concepts: Visual acuity, Myopia, Lens, Eyeglass prescription, Refractive error, Photorefractive keratectomy

145

To compare the changes in anterior and posterior corneal elevations after combined transepithelial photorefractive keratectomy (PRK) and accelerated corneal collagen cross-linking (CXL) and after PRK.

Concepts: Photorefractive keratectomy

28

To assess the long-range outcomes of photorefractive keratectomy (PRK) using functional and topographic criteria in myopic eyes with suspected keratoconus.

Concepts: Ophthalmology, Myopia, LASIK, Photorefractive keratectomy, Phototherapeutic keratectomy

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PURPOSE: To explore the use of the Pulsar Z1 solid-state 213 nm photorefractive laser platform in topography-guided transepithelial photorefractive keratectomy (PRK) for irregular astigmatism. SETTING: Moorfields Eye Hospital, London, United Kingdom. DESIGN: Prospective clinical case series. METHODS: Patients with irregular astigmatism after previous refractive surgery or corneal transplantation were treated with topography-guided transepithelial PRK. Preoperatively and 1-year postoperatively, corrected distance visual acuity (CDVA) and secondary outcome measures (including manifest refraction, contrast sensitivity, haze score, index of surface variation, root-mean-square higher-order aberrations, and subjective visual change) were compared between groups. Adjunctive mitomycin-C was not used. RESULTS: Seven patients had previous refractive surgery, and 7 had previous corneal transplantation. All but 2 patients with a marked haze response had subjective gains in vision and improved CDVA. Gains in CDVA for patients with irregular astigmatism after previous refractive surgery (median 2 lines gain; range 0 to 2 lines gained) were higher than for patients with irregular astigmatism after keratoplasty (median 0 lines; range 5 lines lost to 4 lines gained). Trends in secondary outcome measures were similar, with greater variation in post-keratoplasty patients. Haze scores were higher in post-keratoplasty patients. CONCLUSIONS: 213 nm topography-guided transepithelial PRK was easy to perform and well tolerated by patients with irregular astigmatism. Most patients gained CDVA; however, increased haze responses were observed in post-keratoplasty cases. FINANCIAL DISCLOSURE: Neither author has a financial or proprietary interest in any material or method mentioned.

Concepts: Surgery, Laser, Visual acuity, Cornea, Ophthalmology, LASIK, Keratoconus, Photorefractive keratectomy

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To report the observation of prolonged reepithelialization after photorefractive keratectomy (PRK) associated with the use of besifloxacin 0.6% (Besivance; Bausch & Lomb, Rochester, NY) underneath bandage contact lenses (BCLs) placed during surgery.

Concepts: Cornea, Contact lens, Keratitis, Photorefractive keratectomy, Rochester, New York, Bausch & Lomb, Bausch & Lomb Place, Mount Hope Cemetery, Rochester

27

To assess the effects of adjuvant mitomycin C (MMC) on tear function tests after photorefractive keratectomy (PRK) for myopia.

Concepts: Photorefractive keratectomy, Phototherapeutic keratectomy

0

To evaluate the efficacy and safety of the excimer laser correction of the residual refractive errors after cataract extraction with intraocular lens (IOL) implantation in uncommon cases.

Concepts: Surgery, Ophthalmology, LASIK, Intraocular lens, Phacoemulsification, Eye surgery, Sushruta Samhita, Photorefractive keratectomy

0

To evaluate the safety and efficacy of corneal cross-linking (CXL) followed by photorefractive keratectomy (PRK) for refractive correction in patients with bilateral asymmetric topography.

Concepts: Ophthalmology, Photorefractive keratectomy, Phototherapeutic keratectomy

0

To evaluate the efficacy and safety of topography-guided transepithelial photorefractive keratectomy (PRK) in a group of patients with post-radial keratotomy (RK) showing irregular corneas.

Concepts: Refraction, Ophthalmology, Surgical procedures, Photorefractive keratectomy, Phototherapeutic keratectomy

0

To describe a patient with flap complications after LASIK who was subsequently treated using phototherapeutic keratectomy (PTK) and an autologous lenticule transplant obtained via small incision lenticule extraction (SMILE).

Concepts: Organ transplant, Ophthalmology, LASIK, Eye surgery, Photorefractive keratectomy, Phototherapeutic keratectomy