Taneri Suphi, Kießler Saskia, Rost Anika, Schultz Tim, Dick H Burkhard
Center for Refractive Surgery, Eye Department, St. Francis Hospital, Hohenzollernring 70, 48145 Münster, Germany.
Center for Refractive Surgery, Eye Department, St. Francis Hospital, Münster, Germany.
Ther Adv Ophthalmol. 2021 Jan 22;13:2515841420988215. doi: 10.1177/2515841420988215. eCollection 2021 Jan-Dec.
In Epi-Bowman Keratectomy™ (EBK), a new dynamic multi-blade single-use device (Epi-Clear™, Orca Surgical, Israel) is utilized to remove the epithelium by sweeping movements across the corneal surface. Epithelial cells are discarded. Alcohol or other chemical agents are not utilized. We wanted to compare clinical results of Epi-Clear photorefractive kertectomy (PRK) to alcohol-assisted PRK.
Retrospective, comparative study.
Consecutive case series: Adult patients seeking laser vision correction of myopia or myopic astigmatism without ocular diseases or prior surgery were included. The Epi-Clear PRK group comprised 50 consecutive eyes of 27 patients and the PRK group 50 eyes of 25 patients.
No intraoperative complications occurred. Epi-Clear PRK: At day 1, day 4, and 3 months, uncorrected distance visual acuity (UDVA) was 0.41/0.47/0.93 (decimal scale); epithelial defect diameter was 4.7/0.2/0 (mm); pain level was 3.8/0.3/0 (visual analogue scale, 0-10), respectively. At 3 months, efficacy index was 0.86 and spherical aberrations were unchanged. Three eyes (6%) showed (presumably sterile) infiltrates. PRK: At day 1, day 4, and 3 months, UDVA was 0.56/0.46/1.15; epithelial defect diameter was 6.3/0.2/0 (mm); pain level was 5.0/0.3/0, respectively. At 3 months, efficacy index was 1.1 and spherical aberrations were unchanged.
The new method of epithelial debridement with Epi-Clear before laser ablation seems to offer fast epithelial removal without nicking Bowman's layer (as observed with the laser microscope). However, we found significantly inferior results of Epi-Clear PRK compared to alcohol-assisted PRK. Furthermore, after Epi-Clear PRK corneal infiltrates as a new type of postoperative complication were observed.
在表层-鲍曼角膜切除术（Epi-Bowman Keratectomy™，EBK）中，一种新型的动态多刀片一次性使用设备（Epi-Clear™，以色列奥卡外科公司）被用于通过在角膜表面进行扫动动作来去除上皮。上皮细胞被丢弃。不使用酒精或其他化学药剂。我们想要比较Epi-Clear准分子原位角膜磨镶术（PRK）与酒精辅助PRK的临床结果。
回顾性比较研究。
连续病例系列：纳入寻求近视或近视散光激光视力矫正且无眼部疾病或既往手术史的成年患者。Epi-Clear PRK组包括27例患者的50只连续眼睛，PRK组包括25例患者的50只眼睛。
术中未发生并发症。Epi-Clear PRK：在第1天、第4天和3个月时，未矫正远视力（UDVA）分别为0.41/0.47/0.93（小数视力表）；上皮缺损直径为4.7/0.2/0（mm）；疼痛程度分别为3.8/0.3/0（视觉模拟评分，0 - 10）。在3个月时，疗效指数为0.86，球差无变化。三只眼睛（6%）出现（推测为无菌性）浸润。PRK：在第1天、第4天和3个月时，UDVA分别为0.56/0.46/1.15；上皮缺损直径为6.3/0.2/0（mm）；疼痛程度分别为5.0/0.3/0。在3个月时，疗效指数为1.1，球差无变化。
在激光消融前使用Epi-Clear进行上皮清创的新方法似乎能快速去除上皮且不会划伤鲍曼层（如激光显微镜观察到的）。然而，我们发现Epi-Clear PRK的结果与酒精辅助PRK相比明显较差。此外，在Epi-Clear PRK术后观察到角膜浸润作为一种新型的术后并发症。
