Transepithelial photorefractive keratectomy for myopia and myopic astigmatism.

Aim: Myopia is a growing endemic, especially in the young age groups (E3: 47.2% in 25-29 years old), which is projected to affect up to a staggering 50% of the world's population in the following decades. Transepithelial photorefractive keratomileusis is a novel single-laser refractive surgery that offers advantages in simplicity and corneal biomechanics. Methods: The study reported Trans-PRK results on 71 patients (a total of 137 eyes) with myopia and myopic astigmatism. Results: Mean uncorrected visual acuity at 6 months was 0.02054 logMAR (0.9689 decimal) and at 1 year, 0.02 logMAR (0.9683 decimal); both values were superior to preoperative corrected visual acuity (CDVA). No statistical difference was found between 1 or more months postoperative UCVA and preoperative CDVA (p=0.848-0.723). The efficacy index was over 90% at 1 month and onwards. The safety index was 97% at 1 week and closer to 100% at later follow-up. Cumulative VA 20/20 was achieved in 82.6-89.2% of patients, and 20/25 in 94.2-95.1% of patients. Spherical refraction was +0.13 from plano at 1 month and -0.13 at 6 months; -0.17 at 1 year. Spherical equivalent accuracy was within ±1 D in 87.2% to 95.1% of patients. Vectorial correction index (ideal 1) indicated slight initial overcorrection at 1.19 at 1 month, 1.1 at 6 months, and an almost ideal 1.01 at 1 year; difference vector measured 0.11-0.19D. Discussion: The study reported excellent results using Trans-PRK for the treatment of myopia, as measured by cumulative postoperative uncorrected distance visual acuity, with refractive results aligning with those of comparable studies. Vectorial astigmatism correction was excellent, especially at the 1-year postoperative follow-up, approaching the ideal value. Thus, Trans-PRK offers the expected high-quality correction while presenting biomechanical and simplicity advantages over comparable techniques. Conclusions: Trans-PRK achieved excellent refractive results, a safe profile, and nearly ideal vectorial correction at later follow-up.