Clinical Ophthalmology (Oct 2021)
Two-Step Transepithelial Photorefractive Keratectomy with WaveLight EX500 Platform for Adolescents and Adults with Low to Moderate Myopia: A 12-Month Comparative Evaluation
Abstract
Chulaluck Tangmonkongvoragul,1,2 Sumet Supalaset,3 Napaporn Tananuvat,1,2 Somsanguan Ausayakhun1,2 1Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; 2CMU LASIK Center, Center of Medical Excellence, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; 3Department of Ophthalmology, Chulabhorn Hospital, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok, ThailandCorrespondence: Chulaluck TangmonkongvoragulDepartment of Ophthalmology, Faculty of Medicine, Chiang Mai University, 110 Inthawarorot Road, Sri Phum, Muang, Chiang Mai, 50200, ThailandTel +66 53-935512Fax +66 53-936121Email [email protected]: To compare the visual and refractive results obtained after two-step TransPRK using an EX500 excimer laser for low to moderate myopic correction in adolescents and adults.Patients and Methods: Retrospectively, 91 eyes of 52 patients were categorized into four groups based on age and level of myopia. The demographics, data of efficacy, safety, predictability, stability, and post-operative complications were evaluated at 1, 3, 6, and 12 months post-operatively.Results: At 1-month, adolescents with low myopia achieved the highest mean efficacy index (P =0.034). The efficacy indices continuously increased during the 1-year follow-up in all groups, except in adolescents with moderate myopia. The highest safety and efficacy indices were recorded in adolescents with low myopia at 1-year. Post-operative spherical equivalent within ± 0.50 D at 1 year was 48.75% of all treated eyes; however, the final mean refractive spherical equivalent (MRSE) was under-corrected in all groups. By month 3, the percentage of eyes that had grade 0.5 haze was most prevalent in adolescents with moderate myopia (P < 0.001).Conclusion: two-step TransPRK using an EX500 proved to be an effective, predictable, stable and safe procedure for the correction of low to moderate myopia with or without astigmatism at 1 year. Adolescents with low myopia achieved the best-post-operative UDVA, efficacy and safety indices. Adolescents tolerated night visual problems and dry eye symptoms better than adults.Keywords: transepithelial photorefractive keratectomy, TransPRK, adolescent, two-step PRK, EX500
