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Comparison between mechanical and chemical epithelial removal on photorrefractive keratectomy - symptoms and post-operative epithelial healing

OBJECTIVE: To compare, among patients subjected to PRK, the types and intensity of its post-operative symptoms, between mechanical versus chemical epithelial removal, as well as epithelial healing time. METHODS: We compare the frequency and intensity of referred symptoms by patients that underwent PRK, where each eye underwent one of the different epithelial removal techniques, randomly chosen and in simple-blind format. Additionally, we studied corneal epithelial healing on the fifth postoperative day, in order to observe whether an eventual delay on epithelial healing could interfere on the observed symptoms. RESULTS: Seven patients (10,3%) showed no symptoms on both eyes. Chemical removal showed higher symptom rate among patients with symptoms in only one eye [N=20 (29,4%) versus N=3 (4,4%)]. Among patients with symptoms in both eyes, these were higher on eyes submitted to chemical removal [N=21 (30,9%) versus N=8 (11,8%)]. Values were statistically significant (p<0,001). CONCLUSION: In this study, we observed that chemical epithelial removal with alcohol at 20% causes more symptoms than mechanical in patients undergoing simultaneous PRK in both their eyes.

Photorrefractive keratectomy; Pain measurement; Corneal epithelium


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