Clinical outcomes after laser epithelial keratomileusis (LASEK) and transepithelial photorefractive keratectomy (TPRK) in myopia

Abstract

Objective: To compare the clinical outcomes between laser epithelial keratomileusis (LASEK) and transepithelial photorefractive keratectomy (TPRK) for treatment of myopia. Methods: Case-control study. We reviewed a total of 90 right eyes that underwent either LASEK or TPRK, with 45 eyes in each group (aged between 18 and 40 years; 9 males and 16 females in the LASEK group, and 30 males and 15 females in the TPRK group) from 2015 to 2016 in Peking Union Medical College Hospital and Tangshan Eye Hospital. All the patients were followed up for 6 months postoperatively. Pain, uncorrected visual acuity (UCVA), and haze were measured at postoperative 3 days, 7 days, 1 month, 3 months and 6 months, and compared using an independent Student t-test between the two groups. Degree of haze, eye pain score, and visual acuity were compared by the Mann-Whitney U test. Results: At 3 days, the pain score was 1 (0,3) in the LASEK group versus 0 (0,1) in the TPRK group (Z=5.643, P=0.001). The UCVA was 4.80±0.10 in the LASEK group versus 4.97±0.07 in the TPRK group (Z=6.930, P=0.000) at 3 days, 4.98±0.08 in the LASEK group versus 5.05±0.06 in the TPRK group (Z=8.147, P=0.000) at 7 days, and 5.02±0.05 in the LASEK group versus 5.06±0.06 in the TPRK group (Z=2.381, P=0.017) at 1 month. The UCVA was also measured at 3 months, 5.07±0.07 versus 5.10±0.07 (Z=1.632, P=0.103), and at 6 months, 5.10±0.07 versus 5.11±0.07 (Z=0.798, P=0.425), respectively, with no statistical significance. The residual diopter was (0.17±0.19) D in the LASEK group versus (0.17±0.20) D in the TPRK group (Z=0.097, P=0.923) at 1 month, (0.03±0.11) D versus (0.07±0.14) D (Z=0.166, P=0.096) at 3 months, (0.07±0.13) D versus (0.07±0.14) D (Z=0.002, P=0.978) at 6 months, respectively. The surface regularity index (SRI) was 0.48±0.09 in the LASEK group and 0.46±0.06 in the TPRK group (t=0.88, P=0.37) at 1 month, and 0.49±0.07 in the LASEK group versus 0.47±0.06 in the TPRK group (t=1.53, P=0.132) at 3 months. Transient haze was documented in 1 eye in each group at 1 month (4.4%), with a maximum index of 0.5. No haze was observed in either group at 6 months. Conclusion: TPRK has the advantages of faster early vision recovery and significantly less pain over LASEK. (Chin J Ophthalmol, 2019, 55: 122-126).