Introducing a new techinique for transepithelial surface ablation

Transepithelial surface ablation (TESA) is a new method for performing transepithelial photorefractive keratectomy (t-PRK). It has recently gained impetus as a surface treatment for refractive errors in a single-step process without having to use any surgical instruments contacting the cornea.1-3 Not only do surface ablations have the advantages of maintaining corneal biomechanical strength and eliminating the risks associated with flap-related complications but also enable clinicians to optimise the way the epithelium is removed. Over the past decade, co-workers4-6 assessed the clinical outcomes following t-PRK largely on broad-beam based excimer laser systems. Lee et al4 evaluated that there were no differences in pain, corneal haze formation or uncorrected visual acuity and found t-PRK to yield over-corrections. On the Nidek excimer laser systems (Nidek, Tokyo, Japan) EC5000 and CXIII, Ghadhfan et al5 and Buzzonetti et al6 respectively showed better outcomes following t-PRK. This article discusses the principles involved and the recent experience gained treating myopic refractive errors on the Schwind Amaris excimer laser platform (Schwind eye-tech-solutions, Kleinostheim, Germany).