DILUTE ETHANOL VERSUS MECHANICAL DEBRIDEMENT BEFORE PHOTOREFRACTIVE KERATECTOMY

Purpose: To compare 18% ethanol versus mechanical epithelial debrideme nt in a group of patients having photorefractive keratectomy (PRK) for low to moderate myopia or astigmatism. Setting: Hospital San Jose de Monterrey, Mexico. Methods: This prospective, paired study comprised 1 8 patients who had bilateral PRK between June 1994 and March 1995. One eye had ethanol (alcohol) debridement and the other, mechanical. Time between PRKs was about 6 months. The two groups (alcohol versus mecha nical) were compared for rate of re-epithelialization, refractive outc ome, improvement in uncorrected visual acuity (UCVA), subjective haze grading, and loss of best corrected visual acuity (BCVA). Results: The re was a nonsignificant trend in the alcohol-treated eyes toward a mor e rapid visual recovery. One week after PRK, 76% in the alcohol group but only 31% in the mechanical group had a UCVA of 20/40 or better. Th ere were no significant between-group differences in rate of re-epithe lialization, refractive outcome, subjective haze grading, and loss of BCVA. Conclusion: Chemical de-epithelialization with dilute ethanol ap pears to be a simple, safe, and effective alternative to mechanical sc raping before PRK and might promote faster visual rehabilitation.