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Two-year stability of posterior corneal surface after transepithelial photorefractive keratectomy with a residual stromal thickness less than 350 μm

  • Refractive Surgery
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Abstract

Purpose

This study aimed to investigate the stability of posterior corneal surface 2 years after transepithelial photorefractive keratectomy (TPRK) in patients with a residual stromal thickness less than 350 μm.

Methods

In total, 408 eyes of 212 patients (160 women, 52 men) who underwent TPRK were enrolled in this retrospective study. All surgeries were performed in the Amaris 750S excimer laser platform with smart pulse technology. The posterior corneal elevation, anterior chamber depth, Q value, and curvature were measured using Pentacam preoperatively and postoperatively. All patients were followed up for 2 years. The relationship between percent tissue altered (PTA), age, and changes in posterior corneal surface was analyzed.

Results

The mean preoperative spherical equivalent was − 6.80 ± 1.18 D (range: − 9.00 to − 2.63 D). The mean residual stromal thickness was 336.46 ± 7.25 μm (range: 310–348 μm). The mean PTA was 30.93 ± 2.03% (range: 24.29–35.28%). At 2 years after surgery, the elevation of six points in the central area decreased by 1.91 ± 2.97 μm, 2.98 ± 3.23 μm, 1.17 ± 3.85 μm, 1.70 ± 2.88 μm, 1.36 ± 3.19 μm, and 1.65 ± 3.18 μm, compared with the preoperative value (P < 0.05). The elevation of three points in the peripheral area increased by 1.87 ± 6.34 μm, 0.68 ± 6.00 μm, and 0.95 ± 5.50 μm (P < 0.05). There was no significant linear relationship between PTA, age, and changes in posterior corneal surface, anterior chamber depth, and K2 (all P > 0.05).

Conclusion

Within 2 years after TPRK, the posterior corneal surface remained stable in patients with a residual stromal thickness between 310 and 350 μm. There was no sign of iatrogenic ectasia during the follow-up period.

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Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

This work was supported by the Medical and Health Development Grant of Shandong Province, China (No. 2017WS180).

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Authors and Affiliations

  1. State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Qingdao Eye Hospital of Shandong First Medical University, Eye Institute of Shandong First Medical University, Qingdao, 266071, Shandong Province, China

    Hua Li, Jiafan Zhang, Ting Shao, Huifeng Wang, Sai Liu & Keli Long

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  1. Hua Li
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Contributions

Study conception and design were performed by L. H., S. T., and L. K. L. Data collection was done by L. H., Z. J. F., W. H. F., L. S., and L. K. L. Analysis and interpretation of data was done by L. H., Z. J. F., and L. K. L. Writing the manuscript were performed by L. H., S. T., and L. K. L. Critical revision of the manuscript were performed by L. H., Z. J. F., W. H. F., L. S., and L. K. L. Statistical expertise were performed by L. H., Z. J. F., and S. T. Administrative, technical, or material support were performed by L. K. L. Supervision were performed by L. H. and L. K. L. All authors have reviewed the manuscript and approved the final manuscript.

Corresponding author

Correspondence to Keli Long.

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Ethics approval and consent to participate

The study protocol followed the tenets of the Declaration of Helsinki and was approved by the Ethics Committees of Institutional Review Boards of Qingdao Eye Hospital. All patients were adequately informed about the study as well as the risks and benefits of the surgery and provided signed informed consent to participate.

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Not applicable.

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The authors declare no competing interests.

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Li, H., Zhang, J., Shao, T. et al. Two-year stability of posterior corneal surface after transepithelial photorefractive keratectomy with a residual stromal thickness less than 350 μm. Graefes Arch Clin Exp Ophthalmol 261, 857–865 (2023). https://doi.org/10.1007/s00417-022-05814-3

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