Early Corneal and Epithelial Remodeling Differences Identified by OCT Imaging and Artificial Intelligence Between Two...

Area of Science:

• Ophthalmology
• Refractive Surgery
• Corneal Imaging

Background:

• Transepithelial photorefractive keratectomy (PRK) is a refractive surgery technique.
• Different PRK protocols may influence corneal and epithelial remodeling.
• Optical coherence tomography (OCT) and artificial intelligence (AI) offer advanced methods for analyzing these changes.

Purpose of the Study:

• To compare corneal and epithelial remodeling between SmartSurfACE and Streamlight transepithelial PRK.
• To utilize OCT and AI for quantitative analysis of refractive surgery outcomes.

Main Methods:

• Prospective, interventional, contralateral eye study comparing SmartSurfACE and Streamlight PRK.
• OCT imaging preoperatively and at 1, 3, and 6 months post-surgery.
• Analysis of air-epithelium (A-E) and epithelium-Bowman's layer (E-B) interfaces, epithelium Zernike indices (EZI), visual acuity, and refractive error.

Main Results:

• Both groups showed comparable visual acuity and refractive outcomes.
• Streamlight group exhibited greater changes in A-E aberrations, E-B aberrations, and EZI.
• AI-derived EZI were most indicative of remodeling differences, with Streamlight showing more epithelial distortion and pain.

Conclusions:

• The Streamlight procedure involves greater epithelial removal than SmartSurfACE, leading to early remodeling differences.
• Despite remodeling variations, both transepithelial PRK methods provide similar visual and refractive results.
• AI-powered OCT analysis effectively differentiates corneal remodeling patterns after refractive surgery.