Mechanical versus Alcohol Assisted Epithelial Debridement in Photore-fractive Keratectomy

This study aimed to compare the results and complications of photorefractive keratectomy with alcohol versus mechanical corneal epithelial debridement in myopia and myopic astigmatism.

This prospective comparative interventional study was done on 1250 eyes of 625 patients who were candidate for photorefractive keratectomy. Each patient was randomly assigned to the group of mechanically or alcohol assisted epithelial removal. The epithelium was removed mechanically in one group and with 20% ethylic alcohol in the other group.

658 eyes were in alcohol group and 592 eyes were in non alcohol group. Mean spherical equivalent was -3.8 ± 1.3 D in non alcohol and -4.37 ± 2.3 D in the alcohol group (P = 0.78). There was no significant difference in postoperative pain between two groups (P = 0.22). Uncorrected visual acuity of ≥ 20/20 and ≥ 20/40 were achieved in 90.9% and 98.9% of alcohol group and 93.4% and 99.5% of non alcohol group respectively (P = 0.36 and 0.21). Refraction of ± 1.00 D was achieved in 90% of alcohol and in 92.2% of non alcohol group respectively.

Epithelial removal with diluted ethanol provides a safe, simple and fast technique.