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. 2023 Mar 1;10(1):7.
doi: 10.1186/s40662-023-00327-4.

Twelve-month outcomes of single-step transepithelial photorefractive keratectomy for moderate hyperopia and hyperopic astigmatism

Mahmoud Abdel-Radi #  1 , Mahmoud Rateb #  2 , Mohamed G A Saleh #  2 , Mohamed Omar M Aly #  2
Affiliations

Twelve-month outcomes of single-step transepithelial photorefractive keratectomy for moderate hyperopia and hyperopic astigmatism

Mahmoud Abdel-Radi et al. Eye Vis (Lond). .

Abstract

Background: Conventional mechanical or alcohol-assisted photorefractive keratectomy (PRK) techniques for correction of hyperopia and hyperopic astigmatism were associated with inconsistent results. The aim of this study is to evaluate the 12-month visual and refractive outcomes of the relatively new single-step transepithelial photorefractive keratectomy (TE-PRK) for moderate hyperopia and hyperopic astigmatism.

Methods: This is a prospective interventional study. Forty-eight eyes of 30 patients with moderate hyperopia or hyperopic astigmatism with a cycloplegic spherical equivalent refraction (SEQ) between 2.0 and 4.5 diopters (D) underwent single-step StreamLight® TE-PRK using EX500 excimer laser (Alcon Laboratories, USA). The main outcome measures were recorded at 6 and 12 months postoperatively including assessment of logarithm of the minimum angle resolution (logMAR) uncorrected and corrected distance visual acuity (UDVA, CDVA), cycloplegic refraction, corneal topographic changes as well as post-PRK peripheral haze grading.

Results: The mean preoperative cycloplegic SEQ was significantly reduced from 3.21 ± 0.61 D to 0.35 ± 0.04 D and 0.41 ± 0.04 D at 6 and 12 months, respectively (P < 0.001). The mean preoperative UDVA significantly improved from 0.53 ± 0.02 logMAR to 0.07 ± 0.01 logMAR and 0.08 ± 0.01 logMAR at 6 and 12 months, respectively (P < 0.001) while the mean preoperative logMAR CDVA showed non-significant change over time throughout the study (P = 0.135). At the end of the study, 41 eyes (85.4%) achieved UDVA of 20/25 or better and no eye lost any lines of CDVA. Thirty-eight eyes (79.1%) had a postoperative cycloplegic cylinder of 0.5 D or less at 12 months. The mean preoperative mean keratometry showed significant increase at 6 and 12 months postoperatively (P < 0.001) while there was no significant change between the two postoperative visits denoting topographic stability (P = 0.058). The mean postoperative Q value at 6 and 12 months showed a significant prolate shift (P < 0.001). No haze was observed in 62.5% and 85.4% of the enrolled eyes at 6 and 12 months, respectively.

Conclusions: Single-step StreamLight® TE-PRK for moderate hyperopia and hyperopic astigmatism achieved acceptable visual and refractive outcomes.

Trial registration: (Clinicaltrials.gov): NCT05261685, 2 March 2022, retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT05261685.

Keywords: Hyperopia; Hyperopic PRK; Hyperopic astigmatism; Single-step PRK; StreamLight PRK.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Standard graphs reporting refractive outcomes for single-step transepithelial photorefractive keratectomy (TE-PRK) for moderate hyperopia at 12 months postoperatively. a Uncorrected distance visual acuity (UDVA); b Change in corrected distance visual acuity (CDVA); c Attempted vs. achieved spherical equivalent; d Spherical equivalent refractive accuracy; e Refractive astigmatism; f Stability of spherical equivalent refraction; Postop, postoperative; Preop, preoperative
Fig. 2
Fig. 2
Safety/efficacy index graph. Safety and efficacy indices at 6 and 12 months following single-step transepithelial photorefractive keratectomy (TE-PRK) for moderate hyperopia
Fig. 3
Fig. 3
Postoperative achieved correction and Q value. Correlation between the postoperative achieved correction and Q value at 12 months postoperatively
Fig. 4
Fig. 4
Post-PRK peripheral haze. Two slit-lamp photos of a 38-year-old case with grade 1 peripheral haze at 12 months following bilateral single-step transepithelial photorefractive keratectomy (TE-PRK) for moderate hyperopia. a Right eye; b Left eye
See this image and copyright information in PMC

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