Photorefractive keratectomy using a scanning-slit laser, rotary epithelial brush, and chilled balanced salt solution

• Published in: Journal of cataract and refractive surgery Vol. 26; no. 11; pp. 1596 - 1604
• Main Author: Amoils, S.Percy
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.11.2000; Elsevier Science
• Subjects: Adult; Astigmatism - surgery; Biological and medical sciences; Epithelium, Corneal - surgery; Equipment Design; Humans; Lasers, Excimer; Medical sciences; Myopia - surgery; Ophthalmic Solutions; Photorefractive Keratectomy - methods; Prospective Studies; Reproducibility of Results; Sodium Chloride - administration & dosage; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the eye and orbit; Visual Acuity; Human; Postoperative; Cornea; Cooling; Vision disorder; Myopia; Epithelium; Brush; Photorefractive keratectomy; Eye; Eye disease; Treatment; Surgery; Excimer; Refractive error; Laser; Technique; Astigmatism
• ISSN: 0886-3350; 1873-4502
• DOI: 10.1016/S0886-3350(00)00542-3

To evaluate photorefractive keratectomy (PRK) using a scanning-slit excimer laser combined with removal of the epithelium using a rotary epithelial brush and prebrush and postoperative cooling of the cornea with chilled balanced salt solution (BSS®). Johannesburg Laser Center, Johannesburg, South Africa. In a prospective study, 500 consecutive eyes with myopia ranging from 1.00 to 12.75 diopters (D) and astigmatism up to 6.50 D were treated with PRK using a Nidek EC-5000 scanning-slit excimer laser, removal of the epithelium with a rotary epithelial brush, and prebrush and postlaser cooling of the cornea with chilled BSS (4°C to 6°C). The mean follow-up was 9.32 months (range 1 week to 39 months). Bilateral simultaneous PRK was performed in 238 patients (95.2% of eyes). After 1 week, uncorrected visual acuity was 20/20, 20/25, 20/30, 20/40, 20/60, and 20/80 in 9.80%, 38.60%, 68.20%, 89.40%, 97.80%, and 97.20% of eyes. After 6 months, in 405 eyes, it was 20/15, 20/20, 20/25, 20/30, and 20/40 in 9.38%, 69.88%, 91.11%, 94.81%, and 98.52%. After 12 months, in 222 eyes, it was 20/15, 20/20, 20/25, 20/30, and 20/40 in 6.76%, 68.92%, 83.78%, 91.89%, and 97.30%. After 18 months, in 95 eyes, it was 20/15, 20/20, 20/25, 20/30, and 20/40 in 6.32%, 69.47%, 88.42%, 91.58%, and 96.84%. Six eyes (1.20%) required retreatment. Scanning-slit laser PRK after rotary epithelial scrubbing and prescrub and postlaser cooling allows accurate correction of myopia and astigmatism with minimal regression.