Photorefractive keratectomy using a scanning-slit laser, rotary epithelialbrush, and chilled balanced salt solution

Purpose: To evaluate photorefractive keratectomy (PRK) using a scanning-sli t excimer laser combined with removal of the epithelium using a rotary epit helial brush and prebrush and postoperative cooling of the cornea with chil led balanced salt solution (BSS(R)). Setting: Johannesburg Laser Center, Johannesburg, South Africa. Methods: In a prospective study, 500 consecutive eyes with myopia ranging f rom 1.00 to 12.75 diopters (D) and astigmatism up to 6.50 D were treated wi th PRK using a Nidek EC-5000 scanning-slit excimer laser, removal of the ep ithelium with a rotary epithelial brush, and prebrush and postlaser cooling of the cornea with chilled BSS (4 degreesC to 6 degreesC). The mean follow -up was 9.32 months (range 1 week to 39 months). Bilateral simultaneous PRK was performed in 238 patients (95.2% of eyes). Results: After 1 week, uncorrected visual acuity was 20/20, 20/25, 20/30, 2 0/40, 20/60, and 20/80 in 9.80%, 38.60%, 68.20%, 89.40%, 97.80%, and 97.20% of eyes. After 6 months, in 405 eyes, it was 20/15, 20/20, 20/25, 20/30, a nd 20/40 in 9.38%, 69.88%, 91.11%, 94.81%, and 98.52%. After 12 months, in 222 eyes, it was 20/15, 20/20, 20/25, 20/30, and 20/40 in 6.76%, 68.92%, 83 .78%, 91.89%, and 97.30%. After 18 months, in 95 eyes, it was 20/15, 20/20, 20/25, 20/30, and 20/40 in 6.32%, 69.47%, 88.42%, 91.58%, and 96.84%. Six eyes (1.20%) required retreatment. Conclusions: Scanning-slit laser PRK after rotary epithelial scrubbing and prescrub and postlaser cooling allows accurate correction of myopia and ast igmatism with minimal regression. J Cataract Refract Surg 2000; 26: 1596-16 04 (C) 2000 ASCRS and ESCRS.