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Updated: Nov 28, 2025
Author Spotlight: Advancements in Refractive Surgical Correction for Presbyopia and Exploring Postoperative Visual Acuity
Published on: September 20, 2024
Three-year outcomes of mixed astigmatism correction with single-step transepithelial photorefractive keratectomy with
Bartlomiej J Kaluzny1, Shwetabh Verma, Ilona Piotrowiak-Słupska
1From the Division of Ophthalmology and Optometry, Department of Ophthalmology, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland (Kaluzny, Piotrowiak-Słupska, Kaszuba-Modrzejewska, Rzeszewska-Zamiara, Stachura); Oftalmika Eye Hospital, Bydgoszcz, Poland (Kaluzny, Piotrowiak-Słupska); SCHWIND eye-tech-solutions, Kleinostheim, Germany (Verma, Arba-Mosquera).
Purpose:
To evaluate refractive and visual outcomes of single-step transepithelial photorefractive keratectomy (transPRK) in the treatment of mixed astigmatism with the use of an aberration-neutral profile and large ablation zone.
Setting:
Nicolaus Copernicus University and Oftalmika Eye Hospital, Bydgoszcz, Poland.
Design:
Retrospective, observational case series.
Methods:
This study included patients who underwent transPRK to correct mixed astigmatism and completed the 3-year follow-up. Procedures were performed with an Amaris 750S excimer laser using an aberration-neutral profile and optical zone of 7.2 mm or more.
Results:
A total 48 eyes of 39 patients were included. Preoperatively, mean spherical manifest refraction was +1.37 ± 0.98 diopter (D) (0.25 to 4.00 D), and astigmatism was -4.00 ± 0.76 D (-2.25 to -6.00 D). Three years postsurgery, it was -0.17 ± 0.26 D and -0.41 ± 0.44 D, respectively. Attempted spherical equivalent correction within ±0.50 D was achieved in 45 eyes (94%) and cylindrical correction in 34 (71%). Preoperative corrected distance visual acuity (CDVA) was 20/20 or better in 38 eyes (79%), and postoperative uncorrected was 20/20 or better in 29 eyes (60.0%). No eye had lost 2 or more Snellen lines of CDVA, whereas 3 eyes (6%) gained 2 or more lines. In 4 eyes (8%), haze of low intensity was observed at the periphery, with scores between 0.5 and 1.0, and only 1 eye getting a score of 2 in 0- to 4-degree scale.
Conclusions:
Mixed astigmatism correction with large-ablation-zone transPRK provided good results for efficacy, safety, predictability, and visual outcomes in a 3-year follow-up.
