Transepithelial photorefractive keratectomy - an analysis of the solutions offered by the industry nowadays

TL;DR

This paper compares modern laser systems for a type of eye surgery that removes the eye's surface layer without chemicals, focusing on their technology and results.

Contribution

A detailed comparative analysis of current TransPRK systems from SCHWIND, Alcon, and Bausch + Lomb, highlighting their unique features and clinical outcomes.

Findings

TransPRK eliminates mechanical epithelial removal using excimer lasers, reducing trauma and infection risks.

SCHWIND AMARIS leads in surface quality and visual recovery due to SmartPulse Technology.

WaveLight EX500 and Technolas TENEO offer high-speed ablation and customizable treatment profiles.

Abstract

To review and compare the current commercial solutions for transepithelial photorefractive keratectomy (TransPRK) offered by leading excimer laser manufacturers—SCHWIND eye-tech-solutions (AMARIS with SmartPulse), Alcon (WaveLight EX500), and Bausch + Lomb Technolas (TENEO 317), with a focus on technology, treatment protocols, and clinical outcomes.

TransPRK, a no-touch surface ablation technique, eliminates mechanical or alcohol-based epithelial removal by using the excimer laser to ablate both epithelium and stromal tissue in a single step. This approach offers advantages, including lower epithelial trauma, reduced risk of infection, and faster epithelial healing. Industry innovation has significantly improved TransPRK outcomes through refined epithelial mapping, high-speed ablation, and advanced eye-tracking systems.

All three platforms—SCHWIND AMARIS, WaveLight EX500, and Technolas TENEO—offer effective TransPRK capabilities, each with distinctive advantages. SCHWIND currently leads in terms of surface quality and early visual recovery due to SmartPulse Technology. WaveLight EX500 provides high-speed ablation and robust platform integration, while Technolas TENEO offers customizable epithelial profiles and a user-friendly interface.

In summary, modern TransPRK systems provide safe, effective, and increasingly customizable options for correcting myopia and astigmatism. The choice between platforms depends on a range of factors, including surgical goals, patient profile, available technology, and the surgeon’s familiarity with the system. As laser platforms continue to evolve, further innovations in epithelial mapping, real-time ablation control, and surface smoothing may continue to enhance the outcomes and expand the indications for TransPRK.