Korean J Ophthalmol > Volume 35(2); 2021 > Article
Korean Journal of Ophthalmology 2021;35(2):142-152.
DOI: https://doi.org/10.3341/kjo.2020.0105    Published online February 18, 2021.
Transepithelial Laser versus Alcohol Assisted Photorefractive Keratectomy Safety and Efficacy: 1-Year Follow-up of a Contralateral Eye Study
Hesham Mohamed Gharieb1,2, Mo’mena Ahmad A Awad-Allah1, Anas Adel Ahmed2,3, Ihab Saad Othman2,4
1Department of Ophthalmology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
2Eye World Hospital, Dokki, Giza, Egypt
3Department of Ophthalmology, Faculty of Medicine, Helwan University, Cairo, Egypt
4Department of Ophthalmology, Faculty of Medicine, Cairo University, Giza, Egypt
Correspondence:  Mo’mena Ahmad A Awad-Allah, Tel: 20-10-1515-9486, Fax: 20-2-2434-6753, 
Email: momena@med.asu.edu.eg
Received: 14 August 2020   • Revised: 17 October 2020   • Accepted: 6 January 2021
Abstract
Purpose
To compare single-step transepithelial photorefractive keratectomy (TPRK) to conventional alcohol assisted epithelial removal then photorefractive keratectomy (AAPRK) regarding pain, epithelial healing, visual acuity, corneal haze measured subjectively and objectively, higher order aberrations changes, contrast sensitivity and vector analysis of astigmatic correction with one year follow-up.

Methods
A prospective double-blind randomized study of 29 subjects (58 eyes) who underwent myopic aberration-free laser correction by smart pulse technology using Schwind Amaris 1050 Hz with 1-year follow-up. Right eye was randomly treated by AAPRK or TPRK. Postoperative assessment was performed on day 1 and 3, at 1st week, and 1st, 3rd, 6th, and 12th months. Patients were assessed for pain, epithelial healing, visual acuity, corneal haze, astigmatic correction, higher order aberrations and contrast sensitivity.

Results
Epithelial healing was complete by the 3rd day in 62.1% of AAPRK eyes and in 89.7% of TPRK eyes. First day postoperative pain was higher in TPRK group (p = 0.0134). The decimal uncorrected visual acuity at 12 months was 1.47 ± 0.39 and 1.57 ± 0.38 in the AAPRK and TPRK groups respectively (p = 0.3719). Post-photorefractive keratectomy haze reached a final level of 0.04 ± 0.14 and 0.02 ± 0.1 in AAPRK and TPRK groups respectively (p = 0.5607). Contrast sensitivity was comparable in low and high frequency cycles per degree. Vector analysis of astigmatic correction showed correction index at one year of 0.99 and 1.05 for AAPRK and TPRK groups respectively.

Conclusions
Alcohol assisted and transepithelial photorefractive keratectomy have comparable results regarding safety and efficacy.
Key Words: Alcohol assisted photorefractive keratectomy, Contrast sensitivity, Smart pulse technology, Transepithelial photorefractive keratectomy, Vector analysis
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