Advantages of Surface Ablation in Excimer Laser Surgery

Main Article Content

Fouad Chraibi


In this article, we review the advantages of corneal laser surface surgery to explain the current trend toward this technique. The excimer laser in corneal surface surgery can be used for two reasons. On the one hand, to correct a refractive error by photorefractive keratectomy (PRK) and its two variants; Laser epithelial keratomileusis (LASEK) and Epithelial Laser-assisted in situ keratomileusis (Epi-lasik).

On the other hand, it is used to perform superficial corneal capacities photoablation, among other uses, by Phototherapeutic keratectomy (PTK).

PRK is regaining popularity thanks to its better safety profile, mitomycin C usage and improvement of photoablation profiles. Lasek and Epilasik are less frequently performed nowadays.

PTK is an important element in the techniques used to improve visual acuity in a wide range of corneal conditions such as corneal scars, recurrent erosion syndrome and corneal dystrophies.

Surface ablation, Excimer laser surgery, photorefractive keratectomy, keratomileusis.

Article Details

How to Cite
Chraibi, F. (2020). Advantages of Surface Ablation in Excimer Laser Surgery. Ophthalmology Research: An International Journal, 11(3), 1-7.
Review Article


McDonald MB, Kaufman HE, Frantz JM, Shofner S, Salmeron B, Klyce SD. Excimer laser ablation in a human eye. Case report. Arch. Ophthalmol. 1989;107(5):641–642.

Kim TI, Pak JH, Lee SY, Tchah H. Mitomycin C-induced reduction of keratocytes and fibroblasts after photorefractive keratectomy. Investig. Ophthalmol. & Vis. Sci. 2004;45(9):2978–2984.

Faktorovich EG, Melwani K. Efficacy and safety of pain relief medications after photorefractive keratectomy: Review of prospective randomized trials. J. Cataract. Refract. Surg. 2014;40(10):1716–1730.

Wachtlin J, Langenbeck K, Schründer S, Zhang EP, Hoffmann F. Immunohistology of corneal wound healing after photorefractive keratectomy and laser in situ keratomileusis. J. Refract. Surg. 1999;15(4):451–458.

Munnerlyn CR, Koons SJ, Marshall J. Photorefractive keratectomy: A technique for laser refractive surgery. J. Cataract. Refract. Surg. 1988;14(1):46–52.

Amoils SP. Photorefractive keratectomy using a scanning-slit laser, rotary epithelial brush, and chilled balanced salt solution. J. Cataract. Refract. Surg. 2000;26(11): 1596–1604.

Fadlallah A, et al. Transepithelial photorefractive keratectomy: Clinical results. J. Cataract. Refract. Surg. 2011;37(10):1852–1857.

Luger MHA, Ewering T, Arba-Mosquera S. Consecutive myopia correction with transepithelial versus alcohol-assisted photorefractive keratectomy in contralateral eyes: One-year results. J. Cataract. Refract. Surg. 2012;38(8):1414–1423.

Kanitkar KD, Camp J, Humble H, Shen DJ, Wang MX. Pain after epithelial removal by ethanol-assisted mechanical versus transepithelial excimer laser debridement. J. Refract. Surg. 2000;16(5):519–522.

Na KS, Chung SH, Kim JK, Jang EJ, Lee NR, Joo CK. Comparison of LASIK and surface ablation by using propensity score analysis: A multicenter study in Korea. Investig. Ophthalmol. & Vis. Sci. 2012;53(11):7116–7121.

Sánchez P, Moutsouris K, Pandolfi A. Biomechanical and optical behavior of human corneas before and after photorefractive keratectomy. J. Cataract. Refract. Surg. 2014;40(6):905–917.

Prince J, Chuck RS. Refractive surgery after Descemet’s stripping endothelial keratoplasty. Curr. Opin. Ophthalmol. 2012;23(4):242–245.

Kymionis GD, et al. Long-term results of thin corneas after refractive laser surgery. Am. J. Ophthalmol. 2007;144(2):181– 185.

Hodge C, Lawless M, Sutton G. Keratectasia following LASIK in a patient with uncomplicated PRK in the fellow eye. J. Cataract. Refract. Surg. 2011;37(3): 603–607.

Azar DT, et al. Laser subepithelial keratomileusis: Electron microscopy and visual outcomes of flap photorefractive keratectomy. Curr. Opin. Ophthalmol. 2001;12(4):323–328.

Vinciguerra P, Camesasca FI, Randazzo A. One-year results of butterfly laser epithelial keratomileusis. J. Refract. Surg. 2003;19(2 Suppl):S223–S226.

Wen D, et al. Postoperative efficacy, predictability, safety, and visual quality of laser corneal refractive surgery: A network meta-analysis. Am. J. Ophthalmol. 2017;178:65–78.

Chen CC, Chang JH, Lee JB, Javier J, Azar DT. Human corneal epithelial cell viability and morphology after dilute alcohol exposure. Investig. Ophthalmol. & Vis. Sci. 2002;43(8):2593–2602.

Taneri S, Oehler S, Koch J, Azar D. Effect of repositioning or discarding the epithelial flap in laser-assisted subepithelial keratectomy and epithelial laser in situ keratomileusis. J. Cataract. Refract. Surg. 2011;37(10):1832–1846.

Vinciguerra P, Camesasca FI. Custom phototherapeutic keratectomy with intraoperative topography. J. Refract. Surg. 2004;20(5):S555–S563.

Ashrafzadeh A, Steinert RF. Results of phototherapeutic keratectomy in the management of flap striae after LASIK before and after developing a standardized protocol: Long-term follow-up of an expanded patient population. Ophthalmology. 2007;114(6): 1118–1123.