Transepithelial Photorefractive Keratektomy after a Clear Lens Exchange

Area of Science:

• Ophthalmology
• Refractive Surgery
• Corneal Surgery

Background:

• Refractive lens exchange (RLE) is a common procedure for correcting refractive errors.
• Some patients may require additional refractive correction after RLE.
• Laser vision correction offers a potential solution for post-RLE refractive anomalies.

Purpose of the Study:

• To evaluate the efficacy and refractive outcomes of Transepithelial Photorefractive Keratectomy (TransPRK) after RLE.
• To assess the use of Smart Pulse Technology with static and dynamic cyclotorsion using the Schwind AMARIS 1050 Hz RS laser.
• To determine the predictability of TransPRK for correcting residual ametropia.

Main Methods:

• Retrospective analysis of 552 eyes undergoing RLE between 2016-2019.
• Identified 47 eyes (8.5%) requiring a touch-up procedure.
• Performed TransPRK on 43 eyes with a minimum 3-month follow-up, using a 7.2 mm optical zone centered on the corneal vertex.

Main Results:

• The average age of patients was 57 years.
• Preoperative mean sphere was 0.42 D and astigmatism was 1.06 D.
• Postoperative mean sphere reduced to 0.11 D and astigmatism to 0.25 D.
• Predictability for spherical equivalent of 0.5 D was 91%, and 100% for 1 D.
• No eye lost more than one Snellen line of visual acuity.

Conclusions:

• TransPRK with Smart Pulse Technology is a predictable method for correcting ametropia after clear lens surgery.
• The procedure offers good visual outcomes and refractive accuracy.
• TransPRK serves as an effective secondary treatment for refractive errors post-RLE.