A New Transepithelial Phototherapeutic Keratectomy Mode Using the NIDEK CXIII Excimer Laser

PURPOSE: To evaluate epithelial healing, postoperative pain, and best spectacle-corrected visual acuity (BSCVA) after transepithelial photorefractive keratectomy (PRK) performed with a new phototherapeutic keratectomy (PTK) mode using the NIDEK CXIII excimer laser. METHODS: Fifteen eyes from 10 patients with myopia underwent transepithelial PRK using a multistage program to perform PTK followed by PRK. The PTK incorporated Flex Scan, which accounts for the loss of radial ablation efficiency on the peripheral cornea. The epithelium was removed with the excimer laser by monitoring the disappearance of blue fluorescence during the ablation. Epithelial healing was evaluated by taking slit-lamp photographs every 24 hours until complete reepithelialization. Postoperative pain was measured according to the Faces Pain Rating Scale. All outcomes are reported for 3 months postoperatively. Haze was graded by two ophthalmologists, each masked to the other's result. RESULTS: Mean reepithelialization took 3.50+/-0.85 days, mean pain score was 3.00+/-1.20, and BSCVA was 20/20 for 9 eyes, 20/30 for 3 eyes, and 20/40 for 3 eyes. All patients had haze below grade 2. CONCLUSIONS: The outcomes of the preliminary study show that the incorporation of the Flex Scan algorithm in the PTK mode is as safe and effective as conventional PTK algorithms. The primary advantage of this new PTK mode may be more consistent epithelial removal. Additional studies are needed to determine long-term outcomes.