Clinical outcomes of conventional Vs. transepithelial photorefractive keratectomy: A prospective contralateral eye study.
M Basil Marchi, Adeya Al Harami, Ahmed Maher et al.
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In 30 seconds
This prospective, randomized paired-eye study compared conventional photorefractive keratectomy (PRK) with transepithelial PRK (TransPRK) for myopic correction in 24 patients (48 eyes). Each patient received conventional PRK in one eye and TransPRK in the other, with patients and outcome assessors blinded. Postoperative uncorrected distance visual acuity and final spherical equivalent did not differ significantly, nor did epithelial healing time. TransPRK was associated with greater postoperative pain: median score 8 (IQR 8-10) versus 6 (IQR 6-8) after conventional PRK (p = 0.014).
Key findings
- Postoperative pain was higher after TransPRK: median 8 (IQR 8-10) versus 6 (IQR 6-8) after conventional PRK (p = 0.014).
- Uncorrected distance visual acuity and final spherical equivalent showed no statistically significant differences between procedures (p = 0.084 and p = 0.512, respectively).
- Epithelial healing was faster with TransPRK, but the difference was not statistically significant (p = 0.371).
- Clinically significant postoperative haze occurred in 3 (12.5%) of patients, with the same pattern in both eyes of each affected patient.
Why it matters
The paired-eye design allows comparison of visual, refractive, and recovery outcomes within the same patients. Although the procedures produced comparable visual and refractive results in this cohort, the greater pain reported after TransPRK is relevant to postoperative experience and differs from the pattern described in much of the existing literature, supporting further evaluation.
What to keep in mind
The study included 24 patients, limiting the size of the cohort. The abstract reports no statistically significant difference in epithelial healing despite faster healing with TransPRK.