Comparison of Clinical Results between Transepithelial Photorefractive Keratectomy and Brush Photorefractive Keratectomy

Hyunseung Kang; Chul Myong Choe; Tae Hoon Choi; Se Kyung Kim

doi:10.3341/jkos.2014.55.9.1284

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Kang, Choe, Choi, and Kim: Comparison of Clinical Results between Transepithelial Photorefractive Keratectomy and Brush Photorefractive Keratectomy

Original Article

J Korean Ophthalmol Soc 2014;55(9):1284-1290.

Published online: 2 September 2014

DOI: https://doi.org/10.3341/jkos.2014.55.9.1284

Comparison of Clinical Results between Transepithelial Photorefractive Keratectomy and Brush Photorefractive Keratectomy

Hyunseung Kang, MD, Chul Myong Choe, MD, Tae Hoon Choi, MD, PhD, Se Kyung Kim, MD

Nune Eye Hospital, Seoul, Korea

Address reprint requests to Se Kyung Kim, MD, Nune Eye Hospital, #404 Seolleung-ro, Gangnam-gu, Seoul 135-841, Korea, Tel: 82-2-2086-7750, Fax: 82-2-2086-7710, E-mail: sekyungkim@naver.com

Received 29 November 2013 Revised 8 April 2014 Accepted 20 August 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To compare the results of transepithelial photorefractive keratectomy (trans PRK) and brush-assisted photorefractive keratectomy (brush PRK) for the treatment of myopia.

Methods

A total of 146 eyes from 78 patients who received brush PRK or trans PRK with the Schwind Amaris laser platform were included in the present study. Uncorrected distance visual acuity (UDVA) and manifest refraction spherical equivalent (MRSE) at postoperative 1 week, 1, 3, 6, and 12 months were compared between the 2 groups as well as epithelial healing time.

Results

The mean time to complete epithelial healing was 3.27 ± 0.75 days in the trans PRK group and 3.67 ± 0.93 days in the brush PRK group (p < 0.05). At 1 week after surgery, UDVA recovered more rapidly after trans PRK than brush PRK (brush PRK: 0.13 ± 0.12 log MAR units, trans PRK: 0.09 ± 0.08 log MAR units, p < 0.05), however, UDVA was not significantly different at 1, 3, 6, and, 12 months postoperatively between the 2 groups.

Conclusions

Re-epithelialization and visual recovery were faster in the trans PRK group while visual outcome and postoperative complications were equivalent to the brush PRK group.

Keywords: Brush-assisted photorefractive keratectomy, Epithelial healing time, Transepithelial photorefractive keratectomy

References

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Table 1.

Preoperative patient characteristics

	Brush PRK	Trans PRK	p-value^*
Patients (eyes)	38 (73)	40 (73)
Sex (M/F)	12/26	11/29	0.724
Age (years)	26.3 ± 6.8	28.3 ± 7.1	0.080
CDVA (log MAR)	0.0089 ± 0.0210	0.0048 ± 0.0170	0.196
Sphere (diopter)	−5.34 ± 1.49	−5.05 ± 1.25	0.208
Cylinder (diopter)	−1.02 ± 0.58	−0.84 ± 0.63	0.061
SE (diopter)	−5.85 ± 1.55	−5.46 ± 1.31	0.109
Central corneal thickness (μm)	539 ± 30	536 ± 28	0.480
Mitomycin C use	36 (49%)	33 (45%)	0.622

Values are presented as mean ± SD unless otherwise indicated.

PRK = photorefractive keratectomy; CDVA = corrected distance visual acuity; SE = spherical equivalent.

^* T-test, p < 0.05 is statistically significant.

Table 2.

Comparison of epithelial healing time and mean spherical equivalent between Brush PRK and Trans PRK

	Brush PRK	Trans PRK	p-value
Epithelial healing time (days)	3.67 ± 0.93	3.27 ± 0.75	0.005^*
SE (diopter)
1 week	0.1528 ± 0.5403	0.1069 ± 0.5408	0.615
1 month	−0.0522 ± 0.6851	0.0538 ± 0.6335	0.345
3 months	−0.1033 ± 0.6124	−0.0299 ± 0.5080	0.449
6 months	−0.2687 ± 0.7529	−0.1557 ± 0.5355	0.334
1 year	−0.3082 ± 0.5493	−0.1370 ± 0.6223	0.080

Values are presented as mean ± SD.

PRK = photorefractive keratectomy; SE = spherical equivalent.

^* T-test, p < 0.05 is statistically significant.

Table 3.

Comparison of mean UDVA (log MAR) between Brush PRK and Trans PRK

	Brush PRK	Trans PRK	p-value
1 week	0.1312 ± 0.1200	0.0899 ± 0.0775	0.017^*
1 month	0.0761 ± 0.1689	0.0451 ± 0.0538	0.142
3 months	0.0203 ± 0.0396	0.0231 ± 0.0438	0.692
6 months	0.0261 ± 0.0624	0.0115 ± 0.0334	0.105
12 months	0.0063 ± 0.0188	0.0034 ± 0.0127	0.276

Values are presented as mean ± SD.

UDVA = uncorrected distance visual acuity; PRK = photorefractive keratectomy.

^* T-test, p < 0.05 is statistically significant.

Table 4.

Comparison of epithelial healing time, UDVA, SE adjusted by Mitomycin C use

	Brush PRK	Trans PRK	p-value
Mitomycin C use	36 (49%)	33 (45%)	0.622
Epithelial healing time (days)	3.50 ± 0.08	3.14 ± 0.08	0.002^*
UDVA (log MAR)
1 week	0.123 ± 0.014	0.098 ± 0.013	0.253
1 month	0.050 ± 0.008	0.046 ± 0.008	0.037^*
3 months	0.019 ± 0.005	0.023 ± 0.005	0.230
6 months	0.018 ± 0.005	0.012 ± 0.005	0.248
12 months	0.006 ± 0.002	0.003 ± 0.002	0.394
SE (diopter)
1 week	0.172 ± 0.075	0.127 ± 0.074	0.085
1 month	−0.051 ± 0.092	0.016 ± 0.091	0.382
3 months	−0.119 ± 0.079	−0.064 ± 0.077	0.554
6 months	−0.216 ± 0.088	−0.178 ± 0.087	0.487
12 months	−0.228 ± 0.074	−0.188 ± 0.073	0.912

Values are presented as mean ± SD unless otherwise indicated.

UDVA = uncorrected distance visual acuity; SE = spherical equivalent; PRK = photorefractive keratectomy.

^* ANCOVA test, p <0.05 is statistically significant.

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