Comparison of Conventional Versus Trans-Epithelial Photorefractive Keratectomy in Hyperopia Treatment: A Contralateral Study

Hamidreza Hasani; Mohadeseh Maskan

doi:10.18502/jimc.v6i4.13451

Hamidreza Hasani Department of Ophthalmology, Shahid Madani Hospital, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
Mohadeseh Maskan Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran

DOI: https://doi.org/10.18502/jimc.v6i4.13451

Keywords: Compound hyperopic astigmatism, Conventional photorefractive keratectomy, Hyperopia, Trans-epithelial photorefractive keratectomy

Abstract

Background: This study was planned to compare Trans - epithelial Photorefractive Keratectomy (TPRK) and Alcohol Assisted Photorefractive Keratectomy (AAPRK) laser vision correction in hyperopia and compound hyperopic astigmatism.

Methods: This quasi-experimental study was conducted on patients with hyperopia and hyperopic-astigmatism, whose eye laterality was randomly assigned to undergo TPRK versus AAPRK using SCHWIND AMARIS 1050RS (SCHWIND eye-tech-solutions, Germany). Follow up time was 1, 3, 6 and 12 months after surgery.

Results: 112 eyes of 56 patients with mean age of 32.6 years included, of which 51.8% were female and 48.2% were male. Both TPRK and AAPRK methods were able to correct hyperopia and astigmatism safely and efficiently (p<0.05 in all cases). Postoperative vision characteristics were similar in both methods (p=0.23 for sphere, p=0.52 for cylinder, p=0.064 for axis, and p=0.35 for BCVA) postoperatively. Corneal haze was observed in 44% of the patients with a direct strong correlation with hyperopia severity (r=0.607). Post-operative pain was observed in 60% of the patients with a direct weak correlation with hyperopia severity (r=0.27). Mild photophobia was seen in 42% of the patients with a direct weak correlation between photophobia and hyperopia severity (r=0.36). Epithelial healing time lasted an average of 3.48 days and there was a direct and moderate correlation with hyperopia severity (r=0.4). Safety index in TPRK and AAPRK was 0.54 and 0.45, respectively, with no significant difference (p=0.42); Efficacy index was 0.96 and 0.9 in TPRK and AAPRK, respectively and there was no significant difference between two groups (p=0.23). No complication was observed in all of the patients.

Conclusion: TPRK and AAPRK laser vision correction are both safe and efficient in hyperopia and compound hyperopic astigmatism. There is no significant difference regarding epithelial healing time, post-operative pain and haze formation between two procedures.