PURPOSE:To assess. whether a chemical debridement method for excimer laser
photorefractive keratectomy may lead to better refractive and visual result
s than the standard method which involves the use of a blunt blade to scrap
e off the epithelium.
METHODS: Ninety-three eyes with a mean attempted correction of -5.72 +/- 2.
47 D were debrided using a surgical microsponge after epithelial melting by
20% ethanol solution applied for 20 seconds, and treated by PRK. Results w
ere compared to those from 97 eyes with a mean attempted correction of -6.0
5 +/- 2.46 D, deepithelialized using a Desmarres blade.
RESULTS: Debridement time was faster in the eyes where alcohol was used (P
= .04). During a 6-month follow-up, we found no significant differences in
refractive error, uncorrected, and spectacle-corrected visual acuity. Howev
er, haze rates at were lower (1 month, P = .04), and corneal regularity ind
ex was better (3 months, P = .01) in the eyes deepithelialized using alcoho
l.
CONCLUSIONS: Epithelial debridement using a 20% alcohol solution was faster
to perform, and provided sharper edges and a smoother Bowman's layer surfa
ce than mechanical debridement. This may explain the better results in term
s of haze and corneal regularity.