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Theoretical analyses of the refractive implications of transepithelial PRK ablations
  1. Samuel Arba Mosquera1,2,3,
  2. Shady T Awwad4
  1. 1Department of Research and Development, SCHWIND eye-tech-solutions, Kleinostheim, Germany
  2. 2Recognized Research Group in Optical Diagnostic Techniques, University of Valladolid, Valladolid, Spain
  3. 3Department of Ophthalmology and Sciences of Vision, University of Oviedo, Oviedo, Spain
  4. 4Department of Ophthalmology, American University of Beirut, Beirut, Lebanon
  1. Correspondence to Dr Samuel Arba Mosquera, Department of Research and Development, SCHWIND eye-tech-solutions, Mainparkstr 6-10, Kleinostheim D-63801, Germany;samuel.arba.mosquera{at}eye-tech.net

Abstract

Background/aims To analyse the refractive implications of single-step, transepithelial photorefractive keratectomy (TransPRK) ablations.

Methods A simulation for quantifying the refractive implications of TransPRK ablations has been developed. The simulation includes a simple modelling of corneal epithelial profiles, epithelial ablation profiles as well as refractive ablation profiles, and allows the analytical quantification of the refractive implications of TransPRK in terms of wasted tissue, achieved optical zone (OZ) and induced refractive error.

Results Wasted tissue occurs whenever the actual corneal epithelial profile is thinner than the applied epithelial ablation profile, achieved OZ is reduced whenever the actual corneal epithelial profile is thicker than the applied epithelial ablation profile and additional refractive errors are induced whenever the actual difference centre-to-periphery in the corneal epithelial profile deviates from the difference in the applied epithelial ablation profile.

Conclusions The refractive implications of TransPRK ablations can be quantified using simple theoretical simulations. These implications can be wasted tissue (∼14 µm, if the corneal epithelial profile is thinner than the ablated one), reduced OZ (if the corneal epithelial profile is thicker than ablated one, very severe for low corrections) and additional refractive errors (∼0.66 D, if the centre-to-periphery progression of the corneal epithelial profile deviates from the progression of the ablated one). When TransPRK profiles are applied to normal, not previously treated, non-pathologic corneas, no specific refractive implications associated to the transepithelial profile can be anticipated; TransPRK would provide refractive outcomes equal to those of standard PRK. Adjustments for the planned OZ and, in the event of retreatments, for the target sphere can be easily derived.

  • Cornea
  • Optics and Refraction
  • Treatment Lasers

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