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Comparative study between manual and brush de-epithelization in photorefractive keratectomy (PRK)

Objective:

To compare the influence of two techniques for corneal epithelial removal in photorefractive keratectomy (PRK) - blunt scrape versus rotary brush - regarding duration of technique application, intraoperative comfort, and reepithelization.

Methods:

This prospective randomized study included 58 eyes of 29 patients that underwent simultaneous and sequential PRK in both eyes - blunt scrape (scraped group) in one eye and rotary brush (brushed group) in the fellow eye.

Results:

The faster technique, measured in seconds, was the rotary brush (16.4 ± 6.3) compared to the blunt scrape (35.7 ± 7.6). There was no difference between the methods regarding discomfort reported by the patient during surgery and the type of symptom reported postoperatively (p>0.05). The analysis of variance (ANOVA) showed that the brushed group were related to a greater intensity of symptoms [F (8.104) = 1.5, p<0.05] and post hoc testing indicated that this difference was only significant (p<0.05) on day 2. All eyes of the 2 groups showed complete corneal epithelialization on day 5 postoperatively.

Conclusion:

In this study, it was found that epithelial removal with rotating brush was superior to manual only by its shorter application. It showed the same level of intraoperative discomfort and determined a greater intensity of symptoms postoperatively.

Refractive errors; Photorefractive keratectomy; Cornea; Epithelium; Wound healing; Postoperative period


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