Photorefractive keratectomy using a scanning-slit laser, rotary epithelial brush, and chilled balanced salt solution

PURPOSE: To evaluate photorefractive keratectomy (PRK) using a scanning-slit excimer laser combined with removal of the epithelium using a rotary epithelial brush and prebrush and postoperative cooling of the cornea with chilled balanced salt solution (BSS(R)). SETTING: Johannesburg Laser Center, Johannesburg, South Africa. METHODS: In a prospective study, 500 consecutive eyes with myopia ranging from 1.00 to 12.75 diopters (D) and astigmatism up to 6.50 D were treated with PRK using a Nidek EC-5000 scanning-slit excimer laser, removal of the epithelium with a rotary epithelial brush, and prebrush and postlaser cooling of the cornea with chilled BSS (4 degrees C to 6 degrees C). The mean follow-up was 9.32 months (range 1 week to 39 months). Bilateral simultaneous PRK was performed in 238 patients (95.2% of eyes). RESULTS: After 1 week, uncorrected visual acuity was 20/20, 20/25, 20/30, 20/40, 20/60, and 20/80 in 9.80%, 38.60%, 68.20%, 89.40%, 97.80%, and 97.20% of eyes. After 6 months, in 405 eyes, it was 20/15, 20/20, 20/25, 20/30, and 20/40 in 9.38%, 69.88%, 91.11%, 94.81%, and 98.52%. After 12 months, in 222 eyes, it was 20/15, 20/20, 20/25, 20/30, and 20/40 in 6.76%, 68.92%, 83.78%, 91.89%, and 97.30%. After 18 months, in 95 eyes, it was 20/15, 20/20, 20/25, 20/30, and 20/40 in 6.32%, 69.47%, 88.42%, 91.58%, and 96.84%. Six eyes (1.20%) required retreatment. CONCLUSIONS: Scanning-slit laser PRK after rotary epithelial scrubbing and prescrub and postlaser cooling allows accurate correction of myopia and astigmatism with minimal regression.