Efficacy, safety, and predictability of transepithelial photorefractive keratectomy: meta-analysis

Purpose The aim of this study was to evaluate the efficacy, safety and predictability of transepithelial photorefractive keratectomy (TransPRK) for correcting myopia, astigmatism and hyperopia. Setting Department of Ophthalmology, Saarland University Medical Center, Homburg/Saar, Germany DESIGN:: Meta-analysis of retrospective or prospective studies METHODS:: Relevant studies were collected from Medline and included when meeting the following predefined criteria: randomized controlled trials, at least one of main outcome measures efficacy, safety or predictability and one common TRPK laser ("Schwind Amaris"). The parameters estimates and 95% confidence intervals (CI) were derived from random-effects meta-analysis to account for possible heterogeneity. Results Since hyperopia studies did not meet the inclusion criteria, the results are centered around myopia and astigmatism. Sixteen studies with a total of 1,924 treated eyes were included in the meta-analysis. The mean efficacy, safety and predictability had a probability of 94% CI=0.86-0.97, 0% CI= 0.00-0.03 and 89% CI=0.82-0.93, respectively. The mean correction index, difference vector and index of success had a value of 1.01 CI=1.01-1.02, 0.2 CI=0.06-0.34 and 0.12 CI=0.07-0.18, respectively. Conclusion This summary estimate shows that the TransPRK is highly effective, safe and predictable in correcting myopia and/or astigmatism.