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Dilute ethanol versus mechanical debridement before photorefractive keratectomy
J C Abad1, J H Talamo, J Vidaurri-Leal
1Cornea Service, MEE1/Harvard Medical School, Boston, Massachusetts, USA.
Purpose:
To compare 18% ethanol versus mechanical epithelial debridement in a group of patients having photorefractive keratectomy (PRK) for low to moderate myopia or astigmatism.
Setting:
Hospital San Jose de Monterrey, Mexico.
Methods:
This prospective, paired study comprised 18 patients who had bilateral PRK between June 1994 and March 1995. One eye had ethanol (alcohol) debridement and the other, mechanical. Time between PRKs was about 6 months. The two groups (alcohol versus mechanical) were compared for rate of re-epithelialization, refractive outcome, improvement in uncorrected visual acuity (UCVA), subjective haze grading, and loss of best corrected visual acuity (BCVA).
Results:
There was a nonsignificant trend in the alcohol-treated eyes toward a more rapid visual recovery. One week after PRK, 76% in the alcohol group but only 31% in the mechanical group had a UCVA of 20/40 or better. There were no significant between-group differences in rate of re-epithelialization, refractive outcome, subjective haze grading, and loss of BCVA.
Conclusion:
Chemical de-epithelialization with dilute ethanol appears to be a simple, safe, and effective alternative to mechanical scraping before PRK and might promote faster visual rehabilitation.