Transepithelial photorefractive keratectomy - an analysis of the solutions offered by the industry nowadays

Abstract

Purpose: To review and compare the current commercial solutions for transepithelial photorefractive keratectomy (TransPRK) offered by leading excimer laser manufacturers-SCHWIND eye-tech-solutions (AMARIS with SmartPulse), Alcon (WaveLight EX500), and Bausch + Lomb Technolas (TENEO 317), with a focus on technology, treatment protocols, and clinical outcomes.

Background: TransPRK, a no-touch surface ablation technique, eliminates mechanical or alcohol-based epithelial removal by using the excimer laser to ablate both epithelium and stromal tissue in a single step. This approach offers advantages, including lower epithelial trauma, reduced risk of infection, and faster epithelial healing. Industry innovation has significantly improved TransPRK outcomes through refined epithelial mapping, high-speed ablation, and advanced eye-tracking systems.All three platforms-SCHWIND AMARIS, WaveLight EX500, and Technolas TENEO-offer effective TransPRK capabilities, each with distinctive advantages. SCHWIND currently leads in terms of surface quality and early visual recovery due to SmartPulse Technology. WaveLight EX500 provides high-speed ablation and robust platform integration, while Technolas TENEO offers customizable epithelial profiles and a user-friendly interface.

Conclusion: In summary, modern TransPRK systems provide safe, effective, and increasingly customizable options for correcting myopia and astigmatism. The choice between platforms depends on a range of factors, including surgical goals, patient profile, available technology, and the surgeon's familiarity with the system. As laser platforms continue to evolve, further innovations in epithelial mapping, real-time ablation control, and surface smoothing may continue to enhance the outcomes and expand the indications for TransPRK.

Keywords: CDVA = Corrected distance visual acuity; Excimer laser; LASIK = Laser-Assisted in Situ Keratomileusis; PRK = Photorefractive Keratectomy; PTK = Phototherapeutic Keratectomy; SPT = SmartPulse Technology; SmartPulse; Streamlight; TransEpi PRK; TransPRK; TransPRK = Transepithelial Photorefractive Keratectomy; UDVA = Uncorrected distance visual acuity.