A Clinical and Confocal Microscopic Comparison of Transepithelial PRK and LASEK for Myopia

Korkmaz, Şafak; Bi̇lgi̇han, Kamil; Sül, Sabahattin; Hondur, Ahmet

doi:10.1155/2014/784185

Cited by 11 publications

(7 citation statements)

References 17 publications

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“…A greater reduction in keratocyte density was observed under confocal microscopy after transepithelial PRK at 1–3 months. These results implied a more intense wound healing response after transepithelial PRK compared to LASEK [ 14 ]. But compared with traditional PRK, transepithelial PRK has been seen to result in significantly less haze [ 15 , 16 ].…”

Section: Discussionmentioning

confidence: 99%

Establishing a Porcine Eye Model for Manual Sub-Bowman Layer Photorefractive Keratomileusis

Tian

et al. 2020

Journal of Ophthalmology

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Objective. To establish a porcine eye model for manual sub-Bowman layer photorefractive keratomileusis (SBPRK), which is a reformed surface ablation refractive surgery that results in preserving the corneal Bowman layer (BL). Methods. The SBPRK group consisted of eleven eyes of 8 healthy pigs with BL flaps by mechanical technique followed by laser ablation. Regarding the remaining 5 eyes, 3 random eyes had transepithelium photorefractive keratectomy (TransPRK) (the TransPRK group), while the other 2 eyes were untreated (the blank control group). All the pigs were followed up for 8 weeks. Slit-lamp biomicroscopy and optical coherence tomography (OCT) were examined before the surgeries and at 1 week, 4 weeks, and 8 weeks after the surgeries. Results. In a few days after the surgery, 3 eyes of the SBPRK group were excluded from the study because of poor healing of the corneal flaps. At the 1st postoperative week, one eye had an irregular defect of about 3 mm in the central corneal epithelium area; the cornea of the other 7 eyes had just light edema with intact epithelium just like the cornea of the TransPRK group. At the 4th week, in the SBPRK group, the cornea was slightly hazy (haze stage 1). While in the TransPRK group, the cornea was hazier (haze stage 2). At the 8th week, in the SBPRK group, both corneas were almost transparent, and the edges of the BL flaps could not be clearly seen. Meanwhile, in the TransPRK group, the corneal haze became lighter and thinner. OCT showed that, in the SBPRK group, there was high reflection in the BL layer, and it was obvious at 1 week postoperation, decreased at 4 weeks, and calmed down at 8 weeks. However, in the TransPRK group, the high reflection diffused in the anterior corneal stroma at 1 week postoperation, enhanced at 4 weeks, and weakened at 8 weeks. Conclusions. Preserving the BL while conducting surface refractive surgery may result in less haze than TransPRK. However, further study is still needed, and this technique still requires refining until it becomes a standard clinical procedure.

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Section: Discussionmentioning

confidence: 99%

Establishing a Porcine Eye Model for Manual Sub-Bowman Layer Photorefractive Keratomileusis

Tian

et al. 2020

Journal of Ophthalmology

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“…However, the relatively slow visual recovery and early postoperative pain, mostly due to prolonged total duration of epithelial healing, remain the main disadvantages . In our practice, epithelial closure after conventional PRK is completed in three days in most of the cases . Shortening the epithelial healing duration with novel methods may shorten the duration of pain, and decrease other negative aspects of delayed healing, such as risk for haze and infectious keratitis due to a bare epithelial surface.…”

Section: Discussionmentioning

confidence: 99%

“…In our practice, the duration of epithelial healing was about a day shorter after PRK compared to LASEK . In this study, in addition to testing the effectiveness of AS eye‐drops in epithelial healing after PRK, we intended to develop methods for faster healing following surface ablation.…”

Section: Discussionmentioning

confidence: 99%

Autologous serum eye‐drops and enhanced epithelial healing time after photorefractive keratectomy

Akcam

Ünlü

Karaca

et al. 2018

Clinical and Experimental Optometry

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Background: The aim of the study is to test whether use of autologous serum eye-drops can provide earlier epithelial healing following the application of photorefractive keratectomy. Method: Sixty patients (60 eyes) underwent photorefractive keratectomy for myopia. Thirty eyes received autologous serum drops (Study group) while 30 eyes received conventional artificial tears (Control group) after photorefractive keratectomy. An 8 mm epithelial opening was prepared with the application of 18 per cent alcohol for 20 seconds. Photorefractive keratectomy was performed using ESIRIS excimer laser (SCHWIND, Kleinostheim, Germany) with an optic zone of 6.5 mm. Total duration of epithelial healing was monitored as the main outcome measure. The comparisons were done with chi-square test and independent samples t-test. Statistical significance was considered at p < 0.05. Results: Preoperative myopic spherical refraction and ablation depths were similar in the study and control groups. The mean duration for epithelial healing was about one day shorter in the eyes receiving autologous serum compared to the eyes receiving conventional treatment (2.2 AE 0.25 days versus 3 AE 0 days, p = 0.001). All eyes achieved 6/7.5 or better uncorrected visual acuity in six months. In both groups, more than 90 per cent of eyes were within AE0.50 D of emmetropia in 12 months. No significant difference was noted for the incidence of +1 haze. Conclusion: Use of autologous serum drops reduces epithelial healing duration following surface ablation for two days.

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“…Since the introduction of LASEK to refractive surgery in recent decades, epithelial flaps have successfully been used in subepithelial keratectomy by covering the excimer laser ablation area to reduce inflammation and scarring caused by photorefractive keratectomy [11–13]. …”

Section: Discussionmentioning

confidence: 99%

Active Pedicle Epithelial Flap Transposition Combined with Amniotic Membrane Transplantation for Treatment of Nonhealing Corneal Ulcers

Zhang

Wang

Jia

et al. 2016

Journal of Ophthalmology

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Introduction. The objective was to evaluate the efficacy of active pedicle epithelial flap transposition combined with amniotic membrane transplantation (AMT) in treating nonhealing corneal ulcers. Material and Methods. Eleven patients (11 eyes) with nonhealing corneal ulcer who underwent the combined surgery were included. Postoperatively, ulcer healing time was detected by corneal fluorescein staining. Visual acuity, intraocular pressure, surgical complications, and recurrence were recorded. Corneal status was inspected by the laser scanning confocal microscopy and anterior segment optical coherence tomography (AS-OCT). Results. The primary diseases were herpes simplex keratitis (8 eyes), corneal graft ulcer (2 eyes), and Stevens-Johnson syndrome (1 eye). All epithelial flaps were intact following surgery, without shedding or displacement. Mean ulcer healing time was 10.8 ± 3.1 days, with a healing rate of 91%. Vision significantly improved from 1.70 to 0.82 log MAR (P = 0.001). A significant decrease in inflammatory cell infiltration and corneal stromal edema was revealed 2 months postoperatively by confocal microscopy and AS-OCT. Corneal ulcer recurred in 1 eye. None of the patients developed major complications. Conclusion. Active pedicle epithelial flap transposition combined with AMT is a simple and effective treatment for nonhealing corneal ulcers.

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A Clinical and Confocal Microscopic Comparison of Transepithelial PRK and LASEK for Myopia

Cited by 11 publications

References 17 publications

Establishing a Porcine Eye Model for Manual Sub-Bowman Layer Photorefractive Keratomileusis

Establishing a Porcine Eye Model for Manual Sub-Bowman Layer Photorefractive Keratomileusis

Autologous serum eye‐drops and enhanced epithelial healing time after photorefractive keratectomy

Active Pedicle Epithelial Flap Transposition Combined with Amniotic Membrane Transplantation for Treatment of Nonhealing Corneal Ulcers

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