Epithelial Defect Induced Photorefractive Surgery: Comparison of Two Mechanical Epithelial Removal Techniques
Clinical Medicine Research
Volume 2, Issue 4, July 2013, Pages: 45-47
Received: Apr. 6, 2013;
Published: Jun. 10, 2013
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Aliagha Alishiri, Department of Ophthalmology Bina Eye Hospital, Tehran, Iran
Mostafa Naderi, Department of Ophthalmology Bina Eye Hospital, Tehran, Iran
Khosro Jadidi, Department of Ophthalmology Bina Eye Hospital, Tehran, Iran
Seyed Aliasghar Mosavi, Department of Ophthalmology, Bina Eye Hospital Research center, Tehran, Iran
Purpose: To compare the epithelial defect size after epithelial removal by Weck-Cel sponge (Medtronic) spatula and blunt scalpel hockey blade. Method: This prospective study comprised 100 cases of PRK with mean age of 26±5 years (range, 19 to 45) performed at Bina Eye Specialist Hospital from January to march 2012. The size of epithelium removal was the same in all patients and it was 8.5 mm2. Each patienst’s right eyes epithelium was removed by Weck spounge and it was removed by Haki spatula in the left eye. The residual epithelial defect size was measured in both eyes after 4 days from surgery. Result: Of 200 eyes that met the inclusion criteria, the mean preoperative spherical equivalent (SE) refractive error in right eyes was -2.6±1.5 (Range: -1 to -7 D) versus 2.6±1.4 (Range: -1 to -6.5D) in left eyes (P= 0.527 ). The mean epithelial defect size after 4 days in right eyes was 1.5+- 0.77 and it was 1.46 +- 0.77 in the left eyes (P = 0.623). Conclusion: This sudy showed that there is no difference between corneal epithelial defect size in two methods of PRK surgery after corneal epithelial removal .We consider both methods to be comparable in terms of efficacy and believe the choice of one method over the other rests on the surgeon’s decision and experience.
Seyed Aliasghar Mosavi,
Epithelial Defect Induced Photorefractive Surgery: Comparison of Two Mechanical Epithelial Removal Techniques, Clinical Medicine Research.
Vol. 2, No. 4,
2013, pp. 45-47.
Biswell R. Cornea. In: Riordan-Eva P, Whitcher JP(eds). Vaughan & Asbury’s General Ophthalmology. 16th ed. New York: Lange; 2004: 152
Rajan MS, Jaycock P, O’Brart D, et al. A long-term study of photorefractive keratectomy; 12-year follow-up. Ophthalmology 2004; 111(10): 1813-24.
Weiss, RA, Lih-Huei, L, Liaw, MS, Berns, M, Amoils, SP. (1999) Scanning electron microscopy comparison of corneal epithelial removal techniques before photorefractive keratectomy J Cataract Refract Surg 25, 1093-1096
Griffith, M, Jackson, B, Lafontaine, MD, et al (1998) Evaluation of current techniques of corneal epithelial removal in hyperopic photorefractive keratectomy J Cataract Refract Surg 24, 1070-1078
Pallikaris IG, Karoutis AD, Lydataki SE, Siganos DS. Rotating brush for fast removal of corneal epithelium. J Refract Corneal Surg 1994; 10439-442.
Gimbel HV, DeBroff BM, Beldavs RA, van Westenbrugge JA, Ferensowicz M. Comparison of laser and manual removal of corneal epithelium for photorefractive keratectomy. J Refract Surg 1995; 11: 36-41.
Hersh PS, Brint SF, Maloney RK, Durrie DS, Gordon M, Michelson MA, et al. Photorefractive keratectomy versus laser in situ keratomileusis for moderate to high myopia. A randomized prospective study. Ophthalmology 1998; 105: 1512- 1522.
Pop M, Payette Y. Photorefractive keratectomy versus laser in situ keratomileusis: a controlmatched study. Ophthalmology 2000; 107: 251-257.
Kasetsuwan N, Puangsricharern V, Pariyakanok L. Excimer laser photorefractive keratectomy and laser in situ keratomileusis for myopia and astigmatism. J Med Assoc Thai 2000; 83: 182-192.
10. Ghadhfan F, Al-Rajhi A, Wagoner MD. Laser in situ keratomileusis versus surface ablation: visual outcomes and complications. J Cataract Refract Surg 2007; 33:2041–2048
Ghadhfan F, Al-Rajhi A, Wagoner MD. Laser in situ keratomileusis versus surface ablation: visual outcomes and complications. J Cataract Refract Surg 2007; 33: 2041–2048
Campos M, Hertzog L, Wang XW, Fasano AP, McDonnell PJ. Corneal surface after deepithelialization using a sharp and a dull instrument. Ophthalmic Surg 1992; 23: 618-621.
Lee JB, Seong GJ, Lee JH, et al. Comparison of laser epithelial keratomileusis and photorefractive keratectomy for low o mod-erate myopia. J Cataract Refract Surg 2001; 27:565–570
Buzzonetti L, Petrocelli G, Laborante A, Mazzilli E, Gaspari M, Valenti P, Francia E. A new transepithelial phototherapeutic keratectomy mode using the NIDEK CXIII excimer laser. J Refract Surg 2009; 25: S122–S124
Ali Fadlallah A, Fahed D, Khalil K et al. Transepithelial photorefractive keratectomy:Clinical results: J Cataract Refract Surg Volume 37, Issue 10 , Pages 1852-1857, October 2011.
Luo Lu, Peter S. Reinach and Winston W.-Y. Kao. Corneal Epithelial Wound Healing Experimental Biology and Medicine 2001, 226: 653-664.
Engle AT, Laurent JM, Schallhorn SC, Toman SD, Newacheck JS, Tanzer DJ, Tidwell JL. Masked comparison of silicone hydrogel lotrafilcon A and etafilcon A extended-wear bandage contact lenses after photorefractive keratectomy. J Cataract Refract Surg 2005; 31: 681–686
Abad JC, An B, Power WJ, Foster CS, Azar DT, Talamo JH. A prospective evaluation of alcohol-assisted versus mechanical epithelial removal before photorefractive keratectomy. Ophthalmology. 1997; 104: 1566–1574.
Lee HK, Lee KS, Kim JK, Kim HC, Seo KR, Kim EK. Epithelial healing and clinical outcomes in excimer laser photorefractive surgery following three epithelial removal techniques: mechanical, alcohol, and excimer laser. Am J Ophthalmol. 2005; 139: 56–63.
Ghoreishi1 et al. Alcohol-assisted versus Mechanical Epithelium Removal in Photorefractive Keratectomy. J Ophthalmic Vis Res 2010; 5 (4): 223-227.
Abad JC, Talamo JH, Vidaurri-Leal J, Cantu-Charles C, Helena MC. Dilute ethanol versus mechanical debridement before photorefractive keratectomy.J Cataract RefractSurg.1996; 22: 1427–1433.