There are an important issues and challenges in refractive surgery for select of best procedure for managing of residual refractive errors after the previous refractive surgery especially after radial keratotomy (RK).The aim of this was to evaluate the efficacy and safety of transepithelial photorefractive keratectomy (T-PRK) for the correction of residual refractive errors after RK.

A prospective, uncontrolled non-randomized interventional study was conducted on 22 eyes of 16 patients with a stable refractive error at least one year after RK. All eyes underwent T-PRK with excimer laser. The efficacy, safety, predictability, refractive outcomes, and corneal wavefront aberration changes were assessed in one and six month after the surgery. Intraoperative and postoperative complications were recorded. P values less than 0.05 were considered significant.

The patients’ age ranged from 37 to 61 years (mean 45.77± 4.9), and 9 of 16 patients were male. The preoperative mean MRSE 2.56 ± 1.75(D). The mean UDVA± SD was 0.19± 0.45 log MAR and 0.25 ± 0. 19 log MAR before and after the intervention respectively (P< 0.001). At the end of the study, only one eye (4.5%) lost 2 line of BCVA but two eyes (9.1%) lost 1 line of BSCVA. At 6 month, the mean manifest refraction spherical equivalent (MRSE) was 2.56 ± 1.75 D and 0.11 ± 0.66D in before and after the intervention respectively (P < 0.001). There were statistically significant differences between before and after the intervention regarding mean Defocus Equivalent (P< 0.001).

The results of our study indicate that T-PRK may be an effective and safe method for treating refractive instability in post-RK patients. Study with a longer follow-up and larger number of eyes is needed to confirm the stability of the treatment.