Photorefractive keratectomy using a scanning-slit laser, rotary epithelial brush, and chilled balanced salt solution.
OBJECTIVE
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(R)).


METHODS
Johannesburg Laser Center, Johannesburg, South Africa.


METHODS
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 degrees C to 6 degrees 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).


RESULTS
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.


CONCLUSIONS
Scanning-slit laser PRK after rotary epithelial scrubbing and prescrub and postlaser cooling allows accurate correction of myopia and astigmatism with minimal regression.
Amoils
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SP
Johannesburg Laser Center, Johannesburg, South Africa. percy@icon.co.za
D000328:Adult; D001251:Astigmatism / Q000601:surgery*; D019573:Epithelium, Corneal / Q000601:surgery*; D004867:Equipment Design; D006801:Humans; D054018:Lasers, Excimer; D009216:Myopia / Q000601:surgery*; D009883:Ophthalmic Solutions; D018903:Photorefractive Keratectomy / Q000379:methods*; D011446:Prospective Studies; D015203:Reproducibility of Results; D012965:Sodium Chloride / Q000008:administration & dosage*; D014792:Visual Acuity
D009883:Ophthalmic Solutions; D012965:Sodium Chloride