Transepithelial Laser versus Alcohol Assisted Photorefractive Keratectomy Safety and Efficacy: 1-Year Follow-up of a Contralateral Eye Study

Purpose: To compare single-step transepithelial photorefractive keratectomy (TPRK) to conventional alcohol assisted epithelialremoval then photorefractive keratectomy (AAPRK) regarding pain, epithelial healing, visual acuity, corneal haze measuredsubjectively and objectively, higher order aberrations changes, contrast sensitivity and vector analysis of astigmatic correctionwith one year follow-up. Methods: A prospective double-blind randomized study of 29 subjects (58 eyes) who underwent myopic aberration-freelaser correction by smart pulse technology using Schwind Amaris 1050 Hz with 1-year follow-up. Right eye was randomlytreated by AAPRK or TPRK. Postoperative assessment was performed on day 1 and 3, at 1st week, and 1st, 3rd, 6th, and 12thmonths. Patients were assessed for pain, epithelial healing, visual acuity, corneal haze, astigmatic correction, higher order aberrationsand contrast sensitivity. Results: Epithelial healing was complete by the 3rd day in 62.1% of AAPRK eyes and in 89.7% of TPRK eyes. First day postoperativepain was higher in TPRK group (p = 0.0134). The decimal uncorrected visual acuity at 12 months was 1.47 ± 0.39 and1.57 ± 0.38 in the AAPRK and TPRK groups respectively (p = 0.3719). Post-photorefractive keratectomy haze reached a finallevel of 0.04 ± 0.14 and 0.02 ± 0.1 in AAPRK and TPRK groups respectively (p = 0.5607). Contrast sensitivity was comparable inlow and high frequency cycles per degree. Vector analysis of astigmatic correction showed correction index at one year of 0.99and 1.05 for AAPRK and TPRK groups respectively. Conclusions: Alcohol assisted and transepithelial photorefractive keratectomy have comparable results regarding safety andefficacy.