Epithelial erosions less common in myopic eyes treated with transepithelial vs. alcohol-assisted PRK

This study compared the incidence of epithelial erosions 1 year after transepithelial photorefractive keratectomy (PRK) versus alcohol-assisted PRK.

Study design

Researchers matched 189 eyes that had undergone transepithelial PRK with 189 eyes that had undergone alcohol-assisted PRK. They retrospectively evaluated the incidence and symptoms of epithelial erosions in each group using data gathered from a post hoc patient questionnaire.

Outcomes

Compared with the alcohol-assisted group, the transepithelial group reported less frequent symptoms of subclinical recurrent epithelial erosion, including soreness to touch (6.6% vs. 26.0%), sharp pain (7.9% vs 32.5%) and eyelid sticking (6.6% vs 26.0%; P≤0.002).

Furthermore, the mean time for contact lens removal after treatment was shorter in the transepithelial group (2.6 days) than in the alcohol-assisted group (3.7 days; P<0.001). Only 1% (1/100) of the transepithelial group reported to the clinic due to a tearing and stabbing sensation during the week after contact lens removal, compared with nearly 10% (10/101) of patients in the alcohol-assisted group (P=0.0097).

Limitations

The questionnaire was administered 1 year after PRK, requiring patients to accurately recall details from several months prior. Only patients who returned for a 1-year follow-up exam were included in the study (76% response rate), but the authors do not specify the percent of total surgeries that these patients account for. These factors may have inadvertently biased the results. 

Clinical significance

The incidence of early postoperative epithelial erosions and subsequent subclinical recurrent erosion was lower in myopic eyes treated with transepithelial versus alcohol-assisted PRK. The groups had similar visual outcomes.