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Alcohol versus brush PRK: visual outcomes and adverse effects
Rose K Sia1, Denise S Ryan, Richard D Stutzman
1U.S. Army Warfighter Refractive Surgery Research Center at Fort Belvoir, Fort Belvoir Community Hospital, Fort Belvoir, VA 22060, USA. rose.sia@us.army.mil
Lasers in Surgery and Medicine
|June 8, 2012
Summary
Comparing epithelial removal methods for photorefractive keratectomy (PRK), this study found that while the Amoils epithelial scrubber (brush) had fewer early complications like corneal haze and dry eye, visual outcomes were similar to using 20% ethanol (alcohol) after one month.
Area of Science:
- Ophthalmology
- Refractive Surgery
Background:
- Achieving a smooth corneal surface is crucial for successful refractive outcomes in PRK.
- Epithelial debridement is a key step in PRK, with common methods including mechanical scrubbing and alcohol application.
Purpose of the Study:
- To compare the outcomes of photorefractive keratectomy (PRK) using two epithelial debridement techniques: the Amoils epithelial scrubber (brush) and 20% ethanol (alcohol).
Main Methods:
- A retrospective review of patients undergoing wavefront-optimized PRK for myopia or myopic astigmatism between 2008 and 2010.
- Comparison of uncorrected distance visual acuity (UDVA), manifest refraction spherical equivalent (MRSE), corrected distance visual acuity (CDVA), and complications between brush-treated and alcohol-treated eyes at multiple postoperative intervals (1, 3, 6, and 12 months).
Main Results:
- No significant differences in UDVA, MRSE, or CDVA were observed between the brush and alcohol groups at any postoperative time point beyond 1 month.
- At 1 month postoperatively, the brush group showed a higher percentage of eyes maintaining or gaining CDVA (P=0.007).
- The brush group experienced fewer early postoperative complications, including corneal haze (4.0% vs. 6.9%) and dry eye (8.9% vs. 14.4%), compared to the alcohol group (P=0.032).
Conclusions:
- While 20% ethanol-assisted PRK was associated with more minor early complications like corneal haze and dry eye, visual outcomes were comparable to the brush method beyond the first postoperative month.
- Both epithelial debridement methods yield similar long-term refractive results for PRK.
