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Epithelial healing and clinical outcomes in excimer laser photorefractive surgery following three epithelial removal techniques: Mechanical, alcohol, and excimer laser

Authors
 Hyung Keun Lee  ;  Kyung Sub Lee  ;  Jin Kook Kim  ;  Hyeon Chang Kim  ;  Kyung Ryul Seo  ;  Eung Kweon Kim 
Citation
 AMERICAN JOURNAL OF OPHTHALMOLOGY, Vol.139(1) : 56-63, 2005 
Journal Title
 AMERICAN JOURNAL OF OPHTHALMOLOGY 
ISSN
 0002-9394 
Issue Date
2005
MeSH
Adult ; Corneal Opacity/physiopathology ; Debridement/methods* ; Double-Blind Method ; Epithelium, Corneal/physiology* ; Female ; Humans ; Keratectomy, Subepithelial, Laser-Assisted/methods* ; Lasers, Excimer ; Male ; Myopia/surgery ; Pain Measurement ; Pain, Postoperative/physiopathology ; Photorefractive Keratectomy/methods* ; Prospective Studies ; Refraction, Ocular/physiology ; Refractive Errors/physiopathology ; Treatment Outcome ; Visual Acuity/physiology ; Wound Healing*
Keywords
15652828
Abstract
PURPOSE: To evaluate epithelial healing, postoperative pain, and visual and refractive outcomes after photorefractive keratectomy (PRK) using three epithelial removal techniques. DESIGN: Prospective, nonrandomized, comparative trial. SETTING: Department of Ophthalmology, Yonsei University College of Medicine and Balgensesang Ophthalmology Clinic, Seoul, Korea. INTERVENTIONS: For the PRK procedure, the corneal epithelium was removed in one of three ways: mechanically (conventional PRK [PRK]) in 88 eyes of 44 patients; using excimer laser (transepithelial PRK [tPRK]) in 106 eyes of 53 patients; or using 20% diluted alcohol, laser-assisted subepithelial keratomileusis (LASEK) in 106 eyes of 53 patients. MAIN OUTCOME MEASURES: Epithelial healing, postoperative pain, uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), and remaining refractive error. RESULTS: The mean postoperative pain scores were 4.84 +/- 1.45 for PRK, 4.71 +/- 1.62 for tPRK, and 4.63 +/- 1.52 for LASEK (P = .125). The mean epithelial healing rates were 12.3 +/- 4.6 for PRK, 15.2 +/- 4.9 for tPRK, and 18.1 +/- 5.2 mm2/day for LASEK (P < .001). The postoperative 6-month remaining mean spherical equivalents (diopters) were -0.46 +/- 1.01 for PRK, 0.18 +/- 0.91 for tPRK, and -0.82 +/- 1.18 for LASEK (P = .01). The LASEK group showed less favorable UCVA than other groups. There was no significant difference in BSCVA between the groups. CONCLUSIONS: Postoperative pain, subepithelial opacity and BSCVA were similar regardless of the epithelial removal procedure. A faster epithelial healing rate did not result in better visual or refractive outcomes. Using the same nomogram, tPRK resulted in a slight overcorrection, and LASEK resulted in a slight undercorrection.
Full Text
http://www.sciencedirect.com/science/article/pii/S0002939404010347
DOI
10.1016/j.ajo.2004.08.049
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Ophthalmology (안과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Otorhinolaryngology (이비인후과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Eung Kweon(김응권) ORCID logo https://orcid.org/0000-0002-1453-8042
Kim, Jin Kook(김진국)
Kim, Hyeon Chang(김현창) ORCID logo https://orcid.org/0000-0001-7867-1240
Seo, Kyuong Yul(서경률) ORCID logo https://orcid.org/0000-0002-9855-1980
Lee, Hyung Keun(이형근) ORCID logo https://orcid.org/0000-0002-1123-2136
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/147589
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