Evaluation of the effect of artificial tears on corneal epithelial thickness changes after photorefractive keratectomy

Purpose: This study aimed to evaluate the corneal epithelial thickness changes after photorefractive keratectomy (PRK) and the impact of long‑term artificial tear usage on epithelial thickness changes in these patients. Methods: This study was performed on 71 patients (142 eyes) without dry eye disease who received PRK for myopic refractive correction. The corneal epithelial thickness profile was obtained before, one, three, and six months after surgery using anterior segment optical coherence tomography. Patients were randomly divided into two groups: group A, who received preservative‑free artificial tears post‑surgery, and group B, who did not receive artificial tears. Results: The epithelial thickness decreased universally in the first month and then increased in the 3‑ and 6‑month follow‑ups. Group A had a significantly thicker epithelium in central, paracentral, and midperipheral zones compared with group B in the 3‑month follow‑up. In the 6‑month follow‑up, no significant differences were detected between groups. At the last follow‑up, the central, paracentral, and midperipheral zone epithelial thicknesses in all patients were significantly higher than preoperative values, but peripheral zone thickness only increased to preoperative values. Conclusions: Patients using artificial tears showed a faster thickening, especially in the central and paracentral zones, but there were no significant differences between the two groups in the final follow‑up. Artificial tear usage may increase the rate of the epithelial remodeling process in post‑PRK patients without significantly altering the final epithelial thickness profile. Further studies are warranted to evaluate the influence of different factors on epithelial remodeling. © 2023 Indian Journal of Ophthalmology.