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Purpose <p>To assess refractive outcomes and corneal higher-order aberration changes following transepithelial photorefractive keratectomy (TPRK) performed with large optical zones.</p> Methods <p>Data from 222 eyes of 112 myopic patients undergoing single-step TPRK with Smart Pulse Technology were reviewed retrospectively. Eyes were classified according to programmed optical zone diameter into large optical zone (LOZ, 6.6–7.0&#xa0;mm; n = 57) and extra-large optical zone (XLOZ, 7.1–7.5&#xa0;mm; n = 165) groups. Refractive results, safety and efficacy indices, and corneal wavefront aberrations were assessed at the 6-month follow-up.</p> Results <p>Refractive accuracy was high, with 81.1% of eyes within ± 0.50 D and 98.2% within ± 1.00 D of target refraction at 6&#xa0;months. Safety and efficacy were comparable between the LOZ and XLOZ groups, and no clinically significant haze was observed. Corneal higher-order aberrations increased more in the LOZ group, whereas smaller changes and a slight reduction in coma were observed in the XLOZ group (<i>p</i> &lt; 0.05).</p> Conclusions <p>TPRK performed with large optical zones demonstrated excellent refractive predictability, safety, and efficacy. The use of extra-large optical zones was associated with smaller increases in corneal higher-order aberrations, suggesting that larger optical zones may help preserve postoperative optical quality after TPRK.</p>

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Large optical zone transepithelial PRK: refractive and aberration outcomes

  • 期刊论文

  • 发表日期：

    2026年7月22日

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  • Sultan Kaya Ünsal,
  • Orkun Özkan

摘要

Purpose

To assess refractive outcomes and corneal higher-order aberration changes following transepithelial photorefractive keratectomy (TPRK) performed with large optical zones.

Methods

Data from 222 eyes of 112 myopic patients undergoing single-step TPRK with Smart Pulse Technology were reviewed retrospectively. Eyes were classified according to programmed optical zone diameter into large optical zone (LOZ, 6.6–7.0 mm; n = 57) and extra-large optical zone (XLOZ, 7.1–7.5 mm; n = 165) groups. Refractive results, safety and efficacy indices, and corneal wavefront aberrations were assessed at the 6-month follow-up.

Results

Refractive accuracy was high, with 81.1% of eyes within ± 0.50 D and 98.2% within ± 1.00 D of target refraction at 6 months. Safety and efficacy were comparable between the LOZ and XLOZ groups, and no clinically significant haze was observed. Corneal higher-order aberrations increased more in the LOZ group, whereas smaller changes and a slight reduction in coma were observed in the XLOZ group (p < 0.05).

Conclusions

TPRK performed with large optical zones demonstrated excellent refractive predictability, safety, and efficacy. The use of extra-large optical zones was associated with smaller increases in corneal higher-order aberrations, suggesting that larger optical zones may help preserve postoperative optical quality after TPRK.