Comparison of Postoperative Pain Following Laser-assisted Subepithelial Keratectomy and Transepithelial Photorefractive Keratectomy:a Prospective,Random Paired Bilateral Eye Study

Purpose:To compare postoperative pain following laser-assisted subepithelial keratectomy(LASEK) and transepithelial photorefractive keratectomy(T-PRK, two-step surgery) and alleviate postoperative subjective pain.Methods:.Thirty patients(60 eyes) with myopia or myopic astigmatism were consecutively recruited into this prospective,randomized paired study..Patients underwent LASEK in one eye,and T-PRK in the other. The degree of pain was rated on a scale of 0-10 on postoperative days 1,2 and 3..Uncorrected visual acuity(UCVA) and subepithelial corneal haze were assessed at postoperative 1 and 3 months.Results:.The pain was relieved on the 4th postoperative day in all patients,.healing of corneal epithelium was observed at4-5 days after surgery and contact lenses were removed promptly.At postoperative 1 day,.the mean subjective pain score in the LASEK group was 3.2±1.88 and 4.43±1.61 in TPRK group(P=0.008).No significant difference was found between two groups on postoperative 2 and 3 days. At postoperative 3 months, the percentage of UCVA ≥0.8 in the LASEK group was 100% and 96.7% in the T-PRK group.(P =0.24),93.3% of patients in the LASEK with UCVA ≥1.0 and 90%in the T-PRK group(P=0.64). In the LASEK group, the value of corneal haze was 0.26 ±0.21 and 0.27 ±0.25 in the T-PRK group(P=0.877).Conclusion:.Good visual acuity was obtained in both groups at postoperative 3 months. Compared with those in the T-PRKgroup, patients undergoing had less discomfort in the LASEK group, which may be associated with corneal epithelial activity. The changing curve of subjective pain in the T-PRK group was relatively flat and stable at postoperative 3 days