PURPOSE: This study aims to characterize and compare the patterns of epithelial remodeling following photorefractive keratectomy (PRK) and femtosecond small incision lenticule extraction (Femto-SMILE) using high-resolution anterior segment optical coherence tomography (OCT) imaging. METHODS: In this prospective comparative study, 48 eyes of 24 myopic patients underwent PRK (Group A) or Femto-SMILE (Group B). Preoperative assessments included a full ophthalmologic examination, corneal topography, and epithelial mapping using the MS-39 anterior segment OCT. Postoperative evaluations were conducted at 1 week, 1 month, and 6 months, with epithelial thickness changes analyzed and compared. RESULTS: The mean preoperative minimum epithelial thickness was 42.33 µm in Group A and 44.25 µm in Group B, while the mean maximum epithelial thickness was 54.46 µm and 54.25 µm, respectively. At 6 months, the thinnest epithelial point increased in all patients. There were no statistically significant differences in epithelial thickness in the paracentral quadrants between the two groups. However, the central 3-mm zone exhibited early postoperative epithelial thickening after PRK, which later normalized over time. CONCLUSIONS: PRK and Femto-SMILE exhibited different patterns of epithelial remodeling, with more pronounced early changes observed after PRK. By 6 months, both procedures showed stable epithelial profiles. These findings highlight the value of epithelial mapping in postoperative evaluation and suggest the need for further studies to validate these trends.
Elmassry et al. (Thu,) studied this question.