Transepithelial PhotoRefractive Keratectomy (or TransPRK for short), represents a very recent iteration of laser refractive surgery. The evolution of this form of surgery started with PRK, which was soon overtaken by LASIK, or laser in situ keratomileusis. The reasons for this takeover were that LASIK offered much faster recovery of vision and eye comfort than PRK, where recovery was delayed by the need for the surface cells of the cornea to heal. There is also less risk of corneal scarring and refractive regression with LASIK compared with PRK.
However, LASIK may not be suitable for everyone. Hence, TransPRK has been introduced as a form of laser surface ablation to cater for the group of individuals who are not suitable for LASIK. TransPRK is a non-invasive, no blade surface based procedure; a safer procedure that is suitable for almost everyone, especially if you have been rejected for LASIK.
If you have thin cornea, you may already have been rejected for the LASIK procedure. TransPRK can be your second chance to regain clarity to your unaided vision. Scars from LASIK and Epi-LASIK complications can be treated with TransPRK.
You cannot perform another Epi-LASIK on the same eye because the "blunt" blade cut into the substance of the cornea. Therefore, retreatment with Epi-LASIK is not advised. TransPRK is ideal and recommended for many cases of enhancement even in previous LASIK and Epi-LASIK.
If you have high myopia, much more of your cornea will be used for your correction. With TransPRK, there is no need to create a cornea flap. Therefore, laser ablation begins at the surface of the cornea, leaving the cornea with more cornea after your treatment.
In addition, in high shortsightedness, we strengthen your cornea with accelerated crosslinking and this potentially stabilizes your result and corneal shape and also helps to protect the structural integrity of the cornea. This also potentially prevents the complication called Corneal Ectasia.
Your eyes are probably one of the most important part of your body. At Jerry Tan Eye Surgery, we advise our patients on all the advantages and disadvantages of all laser procedures. We believe you should be advised on choosing a procedure with the most number of advantages for your safety and well-being.
Due to the advancements in technology, it is now possible to conduct the TransPRK surgery in a one step, no touch procedure with the use of the SCHWIND Amaris laser. Using the TransPRK mode, the laser first removes the surface epithelial cells with the excimer laser, and then proceeds immediately with the same laser to remodel the cornea for the refractive correction. Performing surgery in this manner allows all-laser PRK to be carried out in a very short time with minimal manipulation of the eye and in a very gentle way.
The simple answer is that laser technology was not good enough until recently!
In the past, Epi-LASIK was proposed to prevent flap complications and to allow more rapid healing. However, the removal and replacement of the epithelium after an Epi-LASIK "cut" did not increase the speed of healing, in fact, when the epithelial "flap" was replaced after laser ablation, it caused more inflammation and slowed down the healing. This is why in modern day Epi-LASIK, the epithelial "flap" is thrown away.
TransPRK has never been popular because there were no lasers that could do this technique in one step. In the past, to do the equivalent of TransPRK (Customised, TransEpithelial, No-touch surgery or Transepithelial surface ablation), the surgeon had to remove the epithelium with one laser ablation, then re-programme the laser and repeat the laser treatment to correct the shortsightedness and astigmatism. This required a lot of time, exposure of the cornea to drying and resulted in inaccurate results.
At present, only the SCHWIND laser company has managed to discover the best way to do this all in one step and with the faster speed of their lasers especially the 1050RS, the results of TransPRK are now excellent. The removal of the flap is no longer necessary with the blunt blade scraping the cornea during Epi-LASIK. It is now vaporised elegantly with the laser. This one step procedure is safe, rapid and especially good for patients who do not like instruments touching their eye. TransPRK results have been published widely and are equal to any of the best treatments available like in LASIK and Epi-LASIK.