Clinical outcomes of Transepithelial Photorefractive Keratectomy in asymmetric astigmatism

Purpose: To evaluate quantitative and qualitative visual outcomes of Transepithelial Photorefractive Keratectomy (TransPRK) in myopic patients with asymmetric astigmatism.Methods: Sixty four eyes (32 patients) with myopia and asymmetric astigmatism were recruited in this 18-month prospective study at Bina Eye Hospital, Tehran, Iran, from July 2011 to November 2014. All of the eyes underwent one-step refined TransPRK by the same refractive surgeon (S.A.M.) using SCHWIND AMARIS 500 laser. Patients were followed for 18 months. Visual acuity, refraction, contrast sensitivity (CS) and spherical, coma and trefoil higher order aberration (HOA)s were assessed before and after the operation.Results: Fifty eyes (78.13%) belonged to female and 14 eyes (21.89%) to male patients. Mean age of the patients was 26.95±4.36. Mean preoperative spherical equivalent, astigmatism, logMAR UDVA and CDVA were -2.71±2.10, 1.33±1.05, 0.69±0.47 and 0.03±0.27, respectively and by 18 months follow up they improved to 0.01±0.09, 0.01±0.07, -0.07±0.16 and -0.12±0.06, respectively (P < 0.001 for all). All but one eye (98.31%) was within target±0.5 D of refraction. No eye lost two or more lines of preoperative CDVA. Both photopic and mesopic CSs improved (P=0.04 and 0.01, respectively). Ocular wave-front spherical aberration improved (P < 0.001); other ocular or corneal wave-front HOAs did not show a significant change.Conclusion: This long-term data demonstrates efficacy and safety of refined TransPRK by AMARIS 500 laser in correction of myopia and asymmetric astigmatism