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Observational Study
. 2025 Jun 20;45(1):251.
doi: 10.1007/s10792-025-03626-y.

Dry eye after photorefractive keratectomy (PRK) and transepithelial photorefractive keratectomy (T-PRK): a comparative clinical study

Siamak Zarei-Ghanavati  1 , Javad Sadeghi  1 , Samira Hassanzadeh  2 , Mahdieh Shayan Far  2 , Javad Heravian Shandiz  2 , Jamshid Jamali  3 , Ali Abbasi Mehrabadi  2 , Niloofar Irandoost  2 , Sina Aryanmanesh  2 , Ahmad Gharouni  1 , Iman Varshovi-Jaghargh  4
Affiliations
Observational Study

Dry eye after photorefractive keratectomy (PRK) and transepithelial photorefractive keratectomy (T-PRK): a comparative clinical study

Siamak Zarei-Ghanavati et al. Int Ophthalmol. .

Abstract

Purpose: To compare dry eye disease (DED) following PRK and T-PRK surgeries using a combined approach of subjective and objective measures, focusing on clinically meaningful outcomes and adjusted statistical modeling.

Methods: In this prospective observational study, 89 eyes of patients aged over 20 years were enrolled and grouped into PRK (43 eyes) and T-PRK (46 eyes). The primary outcome was change in ocular surface diseases index (OSDI) score at 6 months. Secondary outcomes included non-invasive tear breakup time (NITBUT) and meibomian gland expressibility. Exploratory parameters such as tear meniscus height (TMH), redness score, strip meniscometry (SM Tube), meibomian gland dropout, and meibum quality were also assessed. Statistical models were adjusted for baseline age differences, and corrections for multiple comparisons were applied.

Results: The mean age of the patients was 34.16 ± 7.23 in the PRK and 28.72 ± 6.26 in the T-PRK group (P < 0.001). The two groups were not significantly different for gender (P = 0.367). After statistical adjustment, only the change in OSDI and NITBUT at 1-month remained significant between groups (adjusted P = 0.038 and P < 0.05, respectively). Effect sizes were small to moderate, and none of the differences exceeded minimal clinically important thresholds. Exploratory analyses revealed no significant between-groups differences. Age was identified as an independent predictor of OSDI change.

Conclusion: In short-term follow-up, both procedures induced some degree of DED. However, T-PRK was associated with slightly fewer signs and symptoms of dry eye disease, but the differences were not clinically significant.

Keywords: Dry eye; Photorefractive keratectomy; Refractive surgery; Transepithelial photorefractive keratectomy.

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Conflict of interest statement

Declarations. Conflicts of interest: The authors have not disclosed any conflicts of interests. Consent to participate: Written informed consent was obtained from participants included in the study. Consent for publication: Not applicable. Ethics approval: The study protocol adhered to the tenets of the Declaration of Helsinki and was approved by the ethics committee of Mashhad University of Medical Sciences (Ethical code: IR.MUMS.FHMPM.REC.1400.003). Written informed consent was obtained from all participants before the study.

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References

    1. Cai Y et al (2022) prevalence and incidence of dry eye disease in asia: a systematic review and meta-analysis. Ophthalmic Res 65(6):647–658 - DOI - PubMed
    1. Rabina G et al (2019) The association between preoperative dry eye symptoms and postoperative discomfort in patients underwent photorefractive keratectomy. J Ophthalmol 2019:7029858 - PubMed - PMC
    1. Wang B et al (2015) Dry eye disease following refractive surgery: a 12-month FOLLOW-UP of SMILE versus FS-LASIK in high myopia. J Ophthalmol 2015:132417 - DOI - PubMed - PMC
    1. Nair S et al (2023) Refractive surgery and dry eye—an update. Indian J Ophthalmol 71(4):1105–1114 - DOI - PubMed - PMC
    1. Zhao PF et al (2021) Evaluation of preoperative dry eye in people undergoing corneal refractive surgery to correct myopia. Int J Ophthalmol 14(7):1047–1051 - DOI - PubMed - PMC

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