Impact of teleconsultation on visual and refractive outcomes in patients undergoing laser refractive surgery during COVID-19.

Purpose: To assess the role of remote teleconsultation (TC) follow-up care following a successful and uneventful laser vision correction. Methods: The study is a retrospective, comparative analysis of patients undergoing laser vision correction at tertiary care eye hospital in Southern India. The patients were divided into two groups. The first group included patients operated on before the coronavirus disease (COVID-19) pandemic and were followed up with physical consultations during their follow-up visit (Group 1). The second group comprised patients operated on during the pandemic and had at least one remote TC during their post-operative follow-up (Group 2). Results: A total of 1088 eyes of 564 patients and 717 eyes of 372 patients were included in Group 1 and 2, respectively. The mean number of visits for the patients from Group 2 during the COVID period (2.56 +/- 0.74 days) was significantly lesser (P < 0.0001) than that of Group 1 in the pre-COVID period (3.53 +/- 1.07 days). Close to 90% of the eyes achieved an uncorrected distance visual acuity (UDVA) of 20/20 in both groups (P = 0.925). 96.50% of the eyes in Group 1 and 98.18% of the eyes in Group 2 achieved UCVA 20/25 or better (P = 0.049). Eight eyes (0.73%) in Group 1 and one eye (0.14%) in Group 2 reported a loss of 2 or more lines. However, the results were not statistically significant (P = 0.156). None of the groups had any patients who had a sight-threatening complication. Conclusion: Remote TC following refractive surgery is safe and can be effectively integrated into routine refractive practice to reduce travel to the hospital for a physical consult.

Comparison of Higher-Order Aberrations After Single-Step Transepithelial and Conventional Alcohol-Assisted Photorefractive Keratectomy

Objectives: To compare the asphericity and higher-order aberration (HOA) outcomes of single-step transepithelial photorefractive keratectomy (tPRK) and conventional alcohol-assisted PRK (aaPRK) in patients with myopia and myopic astigmatism. Materials and Methods: Of the 108 eyes of 54 patients enrolled in the study, tPRK was performed on 54 (50%) eyes and aaPRK was performed on 54 (50%) eyes. The following parameters were compared: corrected distance visual acuity (CDVA), spherical equivalent (SE), flat and steep keratometry, intraocular pressure, central corneal thickness, asphericity, and HOAs including horizontal and vertical coma, horizontal and vertical trefoil, spherical aberration, second-order vertical coma, and aberration coefficient. Results: The demographic and baseline characteristics were similar between the two groups (p>0.05, for all). The aberration coefficient value was significantly lower in patients treated with aaPRK compared to patients treated with tPRK at postoperative 3 months, 6 months, and 1 year (p=0.022, p=0.019, and p=0.017, respectively). Differences in the other variables were statistically insignificant (p>0.05 for all). Conclusion: Both tPRK and aaPRK procedures obtain similar postoperative CDVA, SE, asphericity, and HOA outcomes, except the aberration coefficient value.