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Epi-Bowman keratectomy: a new technique for the improvement of outcomes in surface ablation procedures

Session Details

Session Title: Surface Ablation II

Session Date/Time: Tuesday 08/10/2013 | 16:30-18:00

Paper Time: 17:39

Venue: Main Lecture Hall (Ground Floor)

First Author: : A.Gyenes HUNGARY

Co Author(s): :    Z. Nagy              

Abstract Details

Purpose:

To evaluate the clinical results obtained with the Epi-Bowman Keratectomy (EBK) procedure and to compare these results with those obtained with the traditional photorefractive keratectomy (PRK) technique.

Setting:

Semmelweis University, Budapest, Hungary

Methods:

This was a prospective, contralateral eye study of patients scheduled to undergo surface ablation for myopic or hyperopic correction. For each patient, PRK was performed in the left eye using a hockey knife to remove the epithelium. In the right eye, EBK was performed using the Epi-Clear (Orca Surgical, Ashkelon, Israel), a dynamic epikeratome designed specifically for epithelium removal. Surface ablation was followed by excimer laser surgery in all eyes. Distance visual acuity (VA) was measured in all eyes pre-operatively and at post-operative days 1, 2, 3, and 30. Re-epithelialization was measured by optical coherence tomography at post-operative days 1, 2, and 3. Postoperative haze was measured at the 1-month follow-up. Patients were asked to rank pain at 1, 2, and 3 days post-operation.

Results:

The study included 14 eyes of 7 patients. There was no significant difference in mean uncorrected distance visual acuity (UDVA) in EBK and PRK eyes at 1, 2, 3, or 30 days post-op (EBK mean ± standard deviation: 0.66 ± 0.32, 0.56 ± 0.27, 0.66 ± 0.35, and 0.94 ± 0.15, at days 1, 2, 3, and 30 post-op, respectively vs. PRK: 0.63 ± 0.35, 0.58 ± 0.35, 0.52 ± 0.27, and 0.86 ± 0.21 at days 1, 2, 3, and 30 post-op, respectively; p > 0.05). Similarly, there was no significant difference in mean corneal density between the 2 groups (EBK 24.33 ± 3.55 vs. PRK 23.31 ± 4.45). Patients reported similar levels of pain in both groups. However, re-epithelialization was significantly quicker in EBK eyes as compared to PRK eyes. The average diameter of the epithelium-free zone was significantly smaller in EBK eyes than in PRK eyes at days 1 and 2 post-operation (Day 1, EBK: 4.37 ± 0.52 mm vs. PRK: 5.05± 0.70, p < 0.001; Day 2, EBK: 1.08 ± 0.75 mm vs. PRK: 1.89 ± 0.47 mm; p < 0.001). By day 3, re-epithelialization was complete in all EBK eyes.

Conclusions:

The EBK procedure facilitates faster re-epthelialization than the PRK procedure while providing similar visual outcomes to PRK. Therefore, EBK may allow for shorter recovery times than PRK.

Financial Interest:

NONE