Epi-LASIK, TRPK Offer Similar Benefits for Patients With Moderate to High Myopia

Both single-step transepithelial photorefractive keratectomy (TPRK) and off-flap epipolis-laser in situ keratomileusis (Epi-LASIK) are safe, effective and predictable treatments for correcting moderate to high myopia, with similar surgical outcomes, according to a study published in BMC Ophthalmology. 

The prospective self-control study (ClinicalTrial.gov Identifier: NCT05060094) enrolled 64 eyes of 32 patients with moderate to high myopia who were randomly assigned to undergo single-step TPRK in one eye and off-flap Epi-LASIK in the other eye. The researchers evaluated 12 month follow-up results for visual acuity, refraction, ocular high-order aberrations, contrast sensitivity, postoperative pain, epithelial healing, and haze grade. Exclusion criteria consisted of the presence of corneal scars, keratoconus, glaucoma, retinal diseases, or a prior history of corneal or intraocular surgery. 

Researchers found that more eyes completed re-epithelialization in the TPRK group than in the off-flap Epi-LASIK group 3 to 4 days after surgery. By 7 days, all eyes underwent re-epithelialization. The team observed that more eyes achieved visual acuity (both uncorrected distance visual acuities and corrected distance visual acuities) better than 20/20 in the TPRK group than in the off-flap Epi-LASIK group. At 12 months after surgery, the ±0.50 D predictability for correction of the spherical equivalent (SE) was higher in the eyes of the TPRK group (91%) than in the eyes of the off-flap Epi-LASIK group (80%), according to the report.  

The researchers also found no significant differences in ocular aberrations, such as coma, spherical, and trefoil, between the 2 groups at 12 months. They noted that the 2 types of surgical procedures have comparable visual outcomes, epithelium healing time, pain scores, and haze grading. 

“Both TPRK and off-fap Epi-LASIK are safe, effective, and predictable for treating moderate to high myopia,” according to the researchers.

Limitations of the study include the limited sample size and relatively short follow-up duration. 

Reference

Zhang Y, Li T, Li Z, Dai M, Wang Q, Xu Chenchen. Clinical outcomes of single-step transepithelial photorefractive keratectomy and off-flap epipolis-laser in situ keratomileusis in moderate to high myopia: 12-month follow-up. BMC Ophthalmol. Published online May 23, 2022. doi:10.1186/s12886-022-02443-6