To investigate visual quality outcomes and its determinant factors in myopic patients after transepithelial photorefractive keratectomy (TransPRK).

We recruited 132 myopic eyes (132 patients) from Bina Eye Hospital, Tehran, all of which underwent TransPRK using SCHWIND AMARIS 500 laser with aberration-free mode. Visual acuity, refraction, contrast sensitivity (CS), topography, keratometry, and higher order aberrations (HOAs) data were collected before and after the operation. The last follow-up was scheduled 12 months after the surgery. Finally, there was a 5.3% lost to follow-up.

Both mesopic and photopic CSs improved after the surgery (P<0.001). TransPRK improved corneal wave-front (CWF) coma and spherical HOAs in 4-mm diameter analysis (P=0.04 and P=0.03, respectively); however, it induced tetrafoil (P=0.03). In 6-mm diameter, CWF spherical and trefoil HOAs increased (P<0.001 and P=0.03, respectively). The range of mean difference observed in these CWF HOAs was 0.01 – 0.07 µm. However, ocular wave-front spherical aberration decreased significantly (P<0.001). Other aberrations remained unchanged. Using univariate and multiple logistic models, we found larger optical zones, smaller transitional zones, and smaller pupil diameters to be the main predictors of better results in postoperative HOAs and CSs. Preoperative astigmatism, keratometry and corrected distance visual acuity were also associated with the quality of vision indices after the TransPRK.

TransPRK significantly improves CS in myopia. Optical zone, transitional zone, and pupil diameter are the main determinants of visual quality outcomes after the TransPRK.