Anterior segment optical coherence tomography evaluation of corneal epithelium healing time after 2 different surface ablation methods

Abstract

Objectives:To compare epithelial healing time following laser epithelial keratomileusis (LASEK) and photorefractive keratectomy (PRK) with anterior segment optic coherence tomography (AS-OCT).Methods:This prospective interventional case series study comprised 56 eyes of 28 patients that underwent laser refractive surgery in the Department of Ophthalmology, Medipol University Medical Faculty, Istanbul, Turkey, between March 2014 and May 2014. Each patient was randomized to have one eye operated on with PRK, and the other with LASEK. Patients were examined daily for 5 days, and epithelial healing time was assessed by using AS-OCT without removing therapeutic contact lens (TCL). Average discomfort scores were calculated from ratings obtained from questions regarding pain, photophobia, and lacrimation according to a scale of 0 (none) to 5.Results:The mean re-epithelialization time assessed with AS-OCT was 3.07±0.64 days in the PRK group, 3.55±0.54 days in the LASEK group, and the difference was statistically significant (p=0.03). Mean subjective discomfort score was 4.42±0.50 in the PRK eyes, and 2.85±0.44 in the LASEK eyes on the first exam day (p=0.001). The score obtained on the second (p=0.024), and third day (p=0.03) were also statistically significant. The fourth (p=0.069), and fifth days scores (p=0.1) showed no statistically significant difference between groups.Conclusion:The PRK showed a statistically significant shorter epithelial healing time, but had a statistically significant higher discomfort score until the postoperative fourth day compared with LASEK.

Laser-assisted subepithelial keratectomy (LASEK) versus photorefractive keratectomy (PRK) for correction of myopia

“…We included 11 trials that enrolled a total of 428 adult participants with low to moderate myopia (Autrata 2003; Eliacik 2015; Ghanem 2008; Ghirlando 2007; Hashemi 2004a; He 2004; Lee 2001; Litwak 2002; Pirouzian 2004; Rooij 2003; Saleh 2003). Each trial included between 14 and 92 participants.…”

“…Five trials used Nidek EC-5000 (Autrata 2003; Hashemi 2004a; He 2004; Litwak 2002; Saleh 2003), one trial used MEL 70 G-scan (Ghanem 2008), one trial used InPro Laser (Ghirlando 2007), one trial used Keratome II excimer laser (Lee 2001), two trials used VISX Star 3 (Eliacik 2015; Pirouzian 2004), and one trial used the Keratocor 217 floating spot excimer laser (Rooij 2003). Treatment zones also varied among trials.…”

“…Six trials reported the proportion of eyes in each group with UCVA of 20/20 or better for at least one follow-up time point (Eliacik 2015; Ghanem 2008; Ghirlando 2007; Hashemi 2004a; He 2004; Lee 2001). One trial reported the proportion of eyes in each group that lost one or more lines of BSCVA at 12 months (Ghanem 2008).…”

“…Four trials reported the proportion of eyes in each group within ± 0.50 D of target refraction for at least one follow-up time point (Eliacik 2015; Ghanem 2008; Ghirlando 2007; Hashemi 2004a). …”

“…Seven trials reported the mean spherical equivalent in each group for at least one follow-up time point (Autrata 2003; Eliacik 2015; Ghanem 2008; Ghirlando 2007; Hashemi 2004a; He 2004; Lee 2001). …”