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Single-step transepithelial ASLA (SCHWIND) with mitomycin-C for the correction of high myopia: long term follow-up

Authors Aslanides I, Georgoudis P, Selimis V, Mukherjee A

Received 29 August 2014

Accepted for publication 1 October 2014

Published 30 December 2014 Volume 2015:9 Pages 33—41


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr Scott Fraser

Ioannis M Aslanides, Panagiotis N Georgoudis, Vasilis D Selimis, Achyut N Mukherjee

Emmetropia Mediterranean Eye Institute, Heraklion, Crete, Greece

Purpose: We wanted to compare the outcomes of single-step modified transepithelial photorefractive keratectomy (tPRK) termed a SCHWIND all surface laser ablation (ASLA) versus conventional alcohol-assisted photorefractive keratectomy (PRK) and laser-assisted in situ keratomileusis (LASIK) for the correction of higher myopia of 6.00 diopters (D) or more, in an area with high risk of haze due to high intensity of sunlight.
Methods: We used a prospective interventional cohort with matched retrospective control groups. Patients with >6 D myopia and <3.5 D of astigmatism were included. All treatments were performed with the SCHWIND Amaris system using aspheric ablation profiles. Mitomycin C was used in all PRK and ASLA cases. Outcomes were postoperative refraction, visual acuity, stability, and complications. The follow-up period was up to 12 months.
Results: In total, 101 eyes were included after exclusions. Mean preoperative spherical equivalent refraction was −7.9 D, −8.2 D, and −7.4 D in the ASLA (n=41), PRK (n=29), and LASIK (n=31) groups. Mean postoperative spherical equivalent at 12 months postoperatively was −0.1 (standard deviation [SD]: 0.34), −0.2 (SD: 0.59), and −0.08 (SD: 0.36) in the ASLA, PRK, and LASIK groups, with 91.4%, 85.7%, and 83.9% within 0.5 D of target, respectively. Refractive outcomes and regression at 12 months did not vary among groups (P>0.05). Mean logMAR (logarithm of the minimum angle of resolution) uncorrected distance visual acuity at 12 months was 0.00 (SD: 0.05), 0.06 (SD: 0.1), and 0.05 (SD: 0.09) in the ASLA, PRK, and LASIK groups, with significantly better vision in the tPRK group versus LASIK (P=0.01) and PRK (P=0.01) groups.
Conclusion: ASLA (SCHWIND) tPRK with mitomycin C for high myopia demonstrates comparable refractive outcomes to LASIK and PRK, with relatively favorable visual acuity outcomes. There was no increased incidence of haze in the ASLA group.

Keywords: PRK, LASIK, transepithelial PRK, high myopia, ASLA, Mitomycin, epithelium

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