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Mini-PRK: minimally invasive, rapid-recovery Epi-Bowman’s blunt keratectomy (EBK) with limited-zone epithelial removal for myopic PRK: One-year clinical data of a novel technique

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First Author: V.Moustou GREECE

Co Author(s):    A. Kanellopoulos                    

Abstract Details

Purpose:

To evaluate the safety and efficacy of Epi-Bowman’s blunt keratectomy, minimized-zone corneal epithelium removal and topical use of a non-steroidal anti-inflammatory for pain relief, in myopic photorefractive keratectomy (mini-PRK).

Setting:

LaserVision.gr Clinical and Research Eye Institute

Methods:

This prospective case-series included 104 eyes of 52 patients undergoing PRK for bilateral myopia or myopic astigmatism. Epithelial removal was performed using Epi-clearTM epikeratome EBK using customized-shape and diameter, to ablation-zone data. Bromfenac 0.9mg/ml was used through the first postoperative day. Pre-, immediately-post- and following post-operative: Visual acuity, CDVA, UDVA, refraction, post-operative pain measured on a subjective scale, epithelial healing and epithelial mapping profile were evaluated for 12 months.

Results:

The mean postoperative pain scores were 0.27 ± 0.15 on a scale 0 to 4. The mean epithelial defect size at day 2 postoperatively was 1.52 ± 1.23 mm2. 8 eyes were not epithelialized by day 3, and none by day 4. 4 patient’s reported use of additional analgesia. All eyes were 20/25 immediately after the procedure and all 20/25 by day 4. At 3 monthsL UDVA was 20/15,5, Residual refractive error: -0.15 Diopters. Residual manifest cylinder -0.18 Diopters; high order aberrations: 0,21um.

Conclusions:

These data suggest that mini-PRK, may minimize postoperative discomfort and visual debilitation, accelerate re-epithelialization and early visual recovery, compared to traditional larger-epithelial zone PRK and even more-recent trans-epithelial (laser-epithelial removal)-PRK employed for myopic laser vision correction. These data appear superior to LASIK and Smile for the immediate postop rehabilitation and restrictions, similar in discomfort experienced with both of these lamellar procedures, with a potentially superior intra-operative safety profile.

Financial Disclosure:

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