Way Christopher, Elghobaier Mohamed Gamal, Nanavaty Mayank A
University Hospitals Sussex NHS Foundation Trust, Eastern Road, Brighton BN2 5BF, UK.
Brighton & Sussex Medical School, University of Sussex, Falmer, Brighton BN1 9PX, UK.
Vision (Basel). 2024 Mar 21;8(1):16. doi: 10.3390/vision8010016.
The type and nature of refractive surgery procedures has greatly increased over the past few decades, allowing for almost all patient populations to be treated to extremely high satisfaction. Conventional photorefractive keratectomy involves the removal of the corneal epithelium through mechanical debridement or dilute alcohol instillation. An improvement to this method utilises laser epithelial removal in a single-step process termed transepithelial photorefractive keratectomy (transPRK). We explore the history of transPRK from its early adoption as a two-step process, identify different transPRK platforms from major manufacturers, and describe the role of transPRK in the refractive surgery armamentarium. This is a narrative review of the literature. This review finds that TransPRK is a safe and effective procedure that works across a variety of patient populations. Though often not seen as a primary treatment option when compared to other corneal-based procedures that offer a faster and more comfortable recovery, there are many scenarios in which these procedures are not possible. These include, but are not limited to, cases of corneal instability, previous refractive surgery, or transplant where higher-order aberrations can impair vision in a manner not amenable to spectacle or contact lens correction. We discuss refinements to the procedure that would help improve outcomes, including optimising patient discomfort after surgery as well as reducing corneal haze and refractive regression.
在过去几十年里，屈光手术的类型和性质有了极大的增加，几乎所有患者群体都能得到治疗，满意度极高。传统的准分子激光角膜切削术包括通过机械清创或滴注稀释酒精来去除角膜上皮。对这种方法的一种改进是在一个称为经上皮准分子激光角膜切削术（transPRK）的单步过程中利用激光去除上皮。我们探讨了transPRK从早期作为两步法采用以来的历史，识别了主要制造商的不同transPRK平台，并描述了transPRK在屈光手术器械库中的作用。这是一篇文献综述。该综述发现，transPRK是一种安全有效的手术方法，适用于各种患者群体。尽管与其他基于角膜的手术相比，transPRK通常不被视为主要治疗选择，因为后者恢复更快、更舒适，但在许多情况下，这些手术是不可行的。这些情况包括但不限于角膜不稳定、既往屈光手术或移植病例，在这些病例中，高阶像差会以不适合眼镜或隐形眼镜矫正的方式损害视力。我们讨论了有助于改善手术效果的改进措施，包括优化术后患者不适以及减少角膜混浊和屈光回退。
