Clinical Impact of Trans-Photorefractive Keratectomy and Femtosecond Laser In-Situ Keratomileusis in patients with Myopia and Astigmatism

Background: Refractive surgery aims to treat refractive errors by altering the cornea's shape using excimer laser techniques, thereby reducing stromal thickness to focus light rays on the retina. Aim: This study aimed to assess and compare Visual Acuity (VA), Contrast Sensitivity (CS), and Higher Order Aberrations (HOA) in myopic and astigmatic patients undergoing different refractive surgeries. Methods: Conducted at the Amer Eye Hospital Network in Rawalpindi, this study comprised 60 patients (120 eyes). Two groups were examined: 30 Trans-PRK patients (15 myopic, 15 astigmatic) and 30 Femtosecond LASIK patients (15 myopic, 15 astigmatic). Results: Significant differences (P < 0.05) were found in improving VA in both myopic and astigmatic patients’ post-surgery. Trans-PRK yielded superior results compared to Femtosecond LASIK (P < 0.05) in both cases. Contrast sensitivity decreased significantly (P > 0.05) after both surgeries in myopic and astigmatic patients, with Trans-PRK showing better results. Moreover, both operations increased HOAs significantly (P > 0.05) in myopic patients, with Trans-PRK outperforming Femtosecond LASIK. Conclusion: While both Trans-PRK and Femtosecond LASIK improved VA, reduced CS, and increased HOAs, Trans-PRK demonstrated superior outcomes over Femtosecond LASIK in this study.