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Patients report less pain, discomfort with epi-Bowman keratectomy

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NEW ORLEANS — Epi-Bowman keratectomy can offer less pain and less discomfort during surface ablation, according to a speaker here.

Developed by Yariv Bar-On of Israel, the technique involves using an instrument, the Epi Clear device (Orca Surgical), that has a soft polymer tip to lift and remove the epithelium in strips and sheets, Marguerite B. McDonald, MD, FACS, said at Refractive Surgery Subspecialty Day preceding the American Academy of Ophthalmology meeting.

“This is a technology ... that has transformed surface ablation, and the results are now extremely comparable to LASIK. This is a hand-held disposable device with no removable parts that allows the surgeon to remove the epithelium without removing basement membrane or damaging Bowman’s layer,” McDonald said.

In a pilot study, 50 eyes of 25 myopic patients underwent epi-Bowman keratectomy (EBK) with the Epi Clear device compared with 50 eyes that underwent a laser scrape.

“There was a huge difference as far as maximum pain in daily intervals in favor of EBK and the percentage of patients reporting any kind of pain or discomfort. The mean percentage of epithelial recovery was much greater and faster in the EBK group as well,” she said.

Additionally, 98% of EBK patients were within 0.5 D at 6 months compared with 70% of PRK eyes. Also, the 5% of eyes with incidence of grade 2 haze was found only in PRK patients, McDonald said.

“EBK is an improved method of epithelial removal and makes surface ablation, and actually epi-off cross-linking, much more palatable for patients and provides superior clinical outcomes that are comparable to LASIK,” she said. – by Robert Linnehan

Reference:

McDonald MB. The best for surface ablation. Presented at AAO Subspecialty Days; Nov. 10-11, 2017; New Orleans.

Disclosure: McDonald reports she is a consultant for Abbott, Akorn, Allergan, Bausch + Lomb, BlephEx, Focus Labs, Oculus and Shire.