Alhawsawi Abrar, Hariri Jumana, Aljindan Mohanna, Alburayk Khalid, Alotaibi Hammam A
Department of Ophthalmology, Faculty of Medicine, University of Jeddah, Jeddah, SAU.
Department of Ophthalmology, Dhahran Eye Specialist Hospital, Dhahran, SAU.
Cureus. 2023 Mar 29;15(3):e36872. doi: 10.7759/cureus.36872. eCollection 2023 Mar.
Purpose To compare the visual outcome of transepithelial photorefractive keratectomy (PRK) against alcohol-assisted PRK in treating low-to-moderate myopia with or without astigmatism. Setting Dhahran Eye Specialist Hospital, Dhahran, Saudi Arabia. Design This is a retrospective study. Methods Forty eyes of 22 patients with myopia from -0.75 to -6.00 diopters (D) with or without astigmatism from 0 to -3D were included in this study. Preoperative and postoperative data of 20 eyes from 11 patients who underwent transepithelial PRK were compared with 20 eyes from 11 patients who underwent alcohol-assisted PRK were collected and analyzed. The uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest spherical equivalence (SE), manifest cylinder, vector analysis of astigmatism, and efficacy and safety indices were compared between the groups at a mean follow-up of one year postoperatively. Results Baseline characteristics were similar between groups, except the transepithelial PRK group had lower cylinder values than the alcohol-assisted PRK group by 0.69D. Regression analysis was used to control for the difference in the cylinder in all outcome parameters. Both groups had similar mean UDVA (p=0.73), CDVA (p=0.98), the proportion of eyes in either group achieved (20/20, 20/25, and 20/30) UDVA (p=0.72, 0.68 and 0.31 respectively) and percentage of eyes lost two lines of CDVA (p=1.0). There was no statistically significant difference between the two groups in regard to both efficacy and safety indices (p=0.55 and 0.67, respectively). Both groups had similar residual SE (p=0.72), the proportion of eyes within ±0.5D of SE (p=0.29), and residual refractive astigmatism (p=0.87). Both groups had similar difference vectors, surgically induced astigmatism, and correction index (p=0.82, 0.10, and 0.26, respectively). However, the transepithelial PRK group had lower target-induced astigmatism (=0.01), higher magnitude of error (ME; p=0.05), and higher angle of error (AE; p=0.02) than the alcohol-assisted PRK group. Conclusion Transepithelial PRK had similar visual and refractive outcomes as alcohol-assisted PRK. This approach was considered as safe and effective as alcohol-assisted PRK in treating patients with low-to-moderate myopia with or without astigmatism.
目的 比较经上皮准分子激光角膜切削术（PRK）与酒精辅助PRK治疗低度至中度近视伴或不伴散光的视觉效果。地点 沙特阿拉伯达兰的达兰眼科专科医院。设计 这是一项回顾性研究。方法 本研究纳入了22例近视患者的40只眼，近视度数为-0.75至-6.00屈光度（D），伴或不伴0至-3D散光。收集并分析了11例接受经上皮PRK的患者的20只眼和11例接受酒精辅助PRK的患者的20只眼的术前和术后数据。在术后平均随访一年时，比较两组的未矫正远视力（UDVA）、矫正远视力（CDVA）、明显球镜等效度（SE）、明显柱镜、散光矢量分析以及疗效和安全性指标。结果 两组的基线特征相似，但经上皮PRK组的柱镜值比酒精辅助PRK组低0.69D。采用回归分析控制所有结局参数中柱镜的差异。两组的平均UDVA（p = 0.73）、CDVA（p = 0.98）、达到（20/20、20/25和20/30）UDVA的眼比例（分别为p = 0.72、0.68和0.31）以及CDVA下降两行的眼百分比（p = 1.0）相似。两组在疗效和安全性指标方面均无统计学显著差异（分别为p = 0.55和0.67）。两组的残余SE（p = 0.72）、SE在±0.5D范围内的眼比例（p = 0.29）以及残余屈光性散光（p = 0.87）相似。两组的差异矢量、手术诱导散光和矫正指数相似（分别为p = 0.82、0.10和0.26）。然而，经上皮PRK组的目标诱导散光更低（p = 0.01），误差幅度更高（ME；p = 0.05），误差角度更高（AE；p = 0.02）。结论 经上皮PRK与酒精辅助PRK具有相似的视觉和屈光效果。在治疗低度至中度近视伴或不伴散光的患者中，这种方法被认为与酒精辅助PRK一样安全有效。
