Clinical outcomes after alcohol assisted photorefractive keratectomy versus excimer laser assisted epithelial removal photorefractive keratectomy

Srinivasa KH, Maganty V, Kumar KK, Babu GS

Pdf Page Numbers :- 147-152

Srinivasa KH^1,*, Vandana Maganty¹, Kiran Kumar K¹, and Suresh Babu G¹

¹Department of Ophthalmology, Minto Ophthalmic Hospital, Bangalore Medical College And Research Institute, New Tharagupet, Bengaluru, Karnataka 560002, India

*Corresponding author: Dr. Srinivasa KH, Department of Ophthalmology, Minto Ophthalmic Hospital, Bangalore Medical College and Research Institute, New Tharagupet, Bengaluru, Karnataka 560002, India. Email: srinikh@gmail.com

Received 29 February 2022; Revised 29 April 2022; Accepted 10 May 2022; Published 23 May 2022

Citation: Srinivasa KH, Maganty V, Kumar KK, Babu GS. Clinical outcomes after alcohol assisted photorefractive keratectomy versus excimer laser assisted epithelial removal photorefractive keratectomy. J Med Sci Res. 2022; 10(3):147-152. DOI: http://dx.doi.org/10.17727/JMSR.2022/10-27

Copyright: © 2022 Srinivasa KH et al. Published by KIMS Foundation and Research Center. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Abstract

Background: Surface ablation methods as a method of refractive surgery is making a comeback considering its safety, efficacy and the ease of doing the surgery. Various techniques of epithelial debridement in photorefractive keratectomy were described, like mechanical debridement, using 20% alcohol, using excimer laser or using a rotating brush. This study compares two methods of epithelial removal, namely alcohol assisted and excimer laser assisted in patients undergoing photorefractive keratectomy.

Material and methods: A prospective, randomized, interventional study in a tertiary care centre. A total of 50 patients were enrolled, after subjecting them to various test including a detailed history, ocular examination and pentacam. The patients selected were then divided into 2 groups using a randomization software, and the surgery was performed on the de novo eyes. Analysis was done using descriptive statistics namely mean, standard deviation, percentage. Student t test and chi square test was used for the analysis of the data, wherever applicable.

Results: The baseline best corrected visual acuity was 0.03 ± 0.0 in the alcohol assisted photorefractive keratectomy group and 0.03 ± 0.08 in the excimer laser assisted epithelial removal photorefractive keratectomy group. At the end of 6 months, all the patients had a visual acuity of 0.00 on logmar scale. Corneal haze noticed on post-operative day one was 0.98 ± 0.09 in the alcohol assisted photorefractive keratectomy group and 0.94 ± 0.1 in the excimer laser assisted group. No corneal haze was found at the end of one week. Pain scale analysis showed that it was 3.08 ± 0.80 in the alcohol assisted photorefractive keratectomy group and 2.9 ± 0.1 in the excimer laser assisted epithelial removal photorefractive keratectomy group which was not statistically significant. There was no pain at the end of one week.

Conclusion: Various modes of epithelium removal have evolved over time. The two methods of epithelial removal here have similar outcomes in visual outcome, corneal haze and pain, with a good safety margin.

Keywords: photorefractive keratectomy; alcohol assisted; excimer laser; corrected visual acuity; corneal haze; pain scale