{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T19:23:25Z","timestamp":1793042605569,"version":"4.5.0"},"reference-count":30,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2024,10,17]],"date-time":"2024-10-17T00:00:00Z","timestamp":1729123200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Victor Babes University of Medicine and Pharmacy Timisoara"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: This study aims to evaluate the efficacy, safety, and predictability of Transepithelial Photorefractive Keratectomy (TPRK) using the SmartPulse\u00ae technology excimer laser for the correction of myopia and myopic astigmatism, assessing visual and refractive outcomes over a one-year follow-up period. Methods: This retrospective cohort study analyzed data from patients who underwent TPRK at the Ophthalmology Department\u2014\u201cVictor Babes\u201d University of Medicine and Pharmacy in Timisoara (Romania), between January 2019 and June 2023. The procedure was performed using the SmartPulse\u00ae Technology of the SmartSurfACE AMARIS 750S excimer laser (SCHWIND eye-tech-solutions, Kleinostheim, Germany). Preoperative assessments included visual acuity, refraction, and corneal measurements, with postoperative evaluations conducted for up to 12 months. Results: This study included 92 eyes from 46 patients (mean age 29.02 years, 63% male). At 12 months post-op, 100% achieved UDVA 20\/25 or better, with an efficacy index of 1.01. Refractive accuracy was 96% within \u00b10.50 D of the target and astigmatism \u2264 0.50 D in 99% of eyes. The safety index was 1.01. Corneal haze occurred in 8.70% of eyes and was effectively managed with dexamethasone drops. Conclusions: TPRK with the SmartPulse\u00ae technology excimer laser demonstrated high efficacy and safety in correcting myopia and myopic astigmatism, achieving stable visual outcomes over one year. The procedure also showed excellent predictability with a low incidence of complications, supporting its use as a reliable refractive surgery option.<\/jats:p>","DOI":"10.3390\/jcm13206182","type":"journal-article","created":{"date-parts":[[2024,10,17]],"date-time":"2024-10-17T09:14:03Z","timestamp":1729156443000},"page":"6182","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["One-Year Visual and Refractive Outcomes of SmartPulse\u00ae Technology in Transepithelial Photorefractive Keratectomy for Myopic and Astigmatic Patients"],"prefix":"10.3390","volume":"13","author":[{"given":"Daiana-Andreea","family":"Margarit","sequence":"first","affiliation":[{"name":"Ophthalmology Department, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2595-6319","authenticated-orcid":false,"given":"Horia Tudor","family":"Stanca","sequence":"additional","affiliation":[{"name":"Ophthalmology Department, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4950-9962","authenticated-orcid":false,"given":"Valeria","family":"Mocanu","sequence":"additional","affiliation":[{"name":"Ophthalmology Department, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"},{"name":"Oftalmo Sensory-Tumor Research Center-ORL (EYEENT), 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9526-2211","authenticated-orcid":false,"given":"Mihnea","family":"Munteanu","sequence":"additional","affiliation":[{"name":"Ophthalmology Department, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"},{"name":"Oftalmo Sensory-Tumor Research Center-ORL (EYEENT), 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francis","family":"Ferrari","sequence":"additional","affiliation":[{"name":"Clinique Espace Nouvelle Vision, 75006 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suta","family":"Marius","sequence":"additional","affiliation":[{"name":"Ophthalmology Department, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,10,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1097\/j.jcrs.0000000000000487","article-title":"Efficacy, safety, and predictability of transepithelial photorefractive keratectomy: Meta-analysis","volume":"47","author":"Sabau","year":"2021","journal-title":"J. Cataract Refract. Surg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1175","DOI":"10.1097\/j.jcrs.0000000000000611","article-title":"Surface ablation outcomes in high myopia with different epithelium removal techniques","volume":"47","author":"Casanova","year":"2021","journal-title":"J. Cataract Refract. Surg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1106","DOI":"10.1136\/bjophthalmol-2016-309409","article-title":"Single-step transepithelial versus alcohol-assisted photorefractive keratectomy in the treatment of high myopia: A comparative evaluation over 12 months","volume":"101","author":"Antonios","year":"2017","journal-title":"Br. J. Ophthalmol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2085","DOI":"10.1016\/S0140-6736(18)33209-4","article-title":"Refractive surgery","volume":"393","author":"Kim","year":"2019","journal-title":"Lancet"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Way, C., Elghobaier, M.G., and Nanavaty, M.A. (2024). Transepithelial Photorefractive Keratectomy\u2014Review. Vision, 8.","DOI":"10.3390\/vision8010016"},{"key":"ref_6","first-page":"356","article-title":"Photorefractive keratectomy in the correction of astigmatism using Schwind Amaris 750s laser","volume":"6","author":"Baz","year":"2013","journal-title":"Int. J. Ophthalmol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1097\/00004397-200007000-00007","article-title":"Photorefractive keratectomy","volume":"40","author":"Stein","year":"2000","journal-title":"Int. Ophthalmol. Clin."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"756","DOI":"10.4103\/ijo.IJO_1126_19","article-title":"Comparison of single-step transepithelial photorefractive keratectomy and conventional photorefractive keratectomy in low to high myopic eyes","volume":"68","author":"Gadde","year":"2020","journal-title":"Indian J. Ophthalmol."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Zhang, J., Feng, Q., Ding, W., Peng, Y., and Long, K. (2020). Comparison of clinical results between trans-PRK and femtosecond LASIK for correction of high myopia. BMC Ophthalmol., 20.","DOI":"10.1186\/s12886-020-01515-9"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Giral, J.B., Bloch, F., Sot, M., Zevering, Y., El Nar, A., Vermion, J.C., Goetz, C., Lhuillier, L., and Perone, J.M. (2021). Efficacy and safety of single-step transepithelial photorefractive keratectomy with the all-surface laser ablation SCHWIND platform without mitomycin-C for high myopia: A retrospective study of 69 eyes. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0259993"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"142","DOI":"10.3341\/kjo.2020.0105","article-title":"Transepithelial Laser versus Alcohol Assisted Photorefractive Keratectomy Safety and Efficacy: 1-Year Follow-up of a Contralateral Eye Study","volume":"35","author":"Gharieb","year":"2020","journal-title":"Korean J. Ophthalmol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1425","DOI":"10.1016\/j.jfo.2021.05.006","article-title":"Corneal haze post photorefractive keratectomy","volume":"44","author":"Charpentier","year":"2021","journal-title":"J. Fran\u00e7ais Ophtalmol."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Ho, T. (2024). Clinical Outcomes of Transepithelial Photorefractive Keratectomy Performed with Smart Pulse Technology for the Correction of Moderate to High Myopia. J. Clin. Med., 13.","DOI":"10.3390\/jcm13113058"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"5376235","DOI":"10.1155\/2018\/5376235","article-title":"Comparison between Transepithelial Photorefractive Keratectomy versus Alcohol-Assisted Photorefractive Keratectomy in Correction of Myopia and Myopic Astigmatism","volume":"2018","author":"Bakhsh","year":"2018","journal-title":"J. Ophthalmol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1016\/j.clae.2016.11.004","article-title":"Trans advanced surface laser ablation (TransPRK) outcomes using SmartPulseTechnology","volume":"40","author":"Aslanides","year":"2017","journal-title":"Contact Lens Anterior Eye"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1007\/s00417-022-05814-3","article-title":"Two-year stability of posterior corneal surface after transepithelial photorefractive keratectomy with a residual stromal thickness less than 350 \u03bcm","volume":"261","author":"Li","year":"2023","journal-title":"Graefe\u2019s Arch. Clin. Exp. Ophthalmol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"466","DOI":"10.3928\/1081597X-20180402-04","article-title":"Transepithelial photorefractive keratectomy in moderate to high astigmatism with a non-wavefront\u2013Guided aberration-neutral ablation profile","volume":"34","author":"Verma","year":"2018","journal-title":"J. Refract. Surg."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1186\/s40662-021-00254-2","article-title":"SmartSurfACE transepithelial photorefractive keratectomy with mitomycin C enhancement after small incision lenticule extraction","volume":"8","year":"2021","journal-title":"Eye Vis."},{"key":"ref_19","first-page":"459","article-title":"Standard graphs for reporting refractive surgery","volume":"16","author":"Waring","year":"2000","journal-title":"J. Refract. Surg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"975","DOI":"10.3928\/1081597X-20091016-01","article-title":"Graphic reporting of outcomes of refractive surgery","volume":"25","author":"Reinstein","year":"2009","journal-title":"J. Refract. Surg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"7","DOI":"10.3928\/1081597X-20101116-01","article-title":"Standardized graphs and terms for refractive surgery results","volume":"27","author":"Waring","year":"2011","journal-title":"J. Refract. Surg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jcrs.2010.11.010","article-title":"Standardized graphs and terms for refractive surgery results","volume":"37","author":"Dupps","year":"2011","journal-title":"J. Cataract Refract. Surg."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"945","DOI":"10.1097\/ICO.0b013e31820a0e53","article-title":"Standardized graphs and terms for refractive surgery results","volume":"30","author":"Stulting","year":"2011","journal-title":"Cornea"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"654","DOI":"10.3928\/1081597X-20140903-01","article-title":"JRS standard for reporting astigmatism outcomes of refractive surgery","volume":"30","author":"Reinstein","year":"2014","journal-title":"J. Refract. Surg."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2575","DOI":"10.1007\/s10792-021-01816-y","article-title":"Transepithelial photorefractive keratectomy to treat mild myopia","volume":"41","author":"Alasmari","year":"2021","journal-title":"Int. Ophthalmol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/j.joco.2019.01.003","article-title":"Comparison of mechanical debridement and trans-epithelial myopic photorefractive keratectomy: A contralateral eye study","volume":"31","author":"Shandiz","year":"2019","journal-title":"J. Curr. Ophthalmol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e241144","DOI":"10.1136\/bcr-2020-241144","article-title":"Transepithelial photorefractive keratectomy for the management of hyperopic regression after conductive keratoplasty","volume":"14","author":"Meduri","year":"2021","journal-title":"BMJ Case Rep."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"450","DOI":"10.1097\/j.jcrs.0000000000000476","article-title":"Three-year outcomes of mixed astigmatism correction with single-step transepithelial photorefractive keratectomy with a large ablation zone","volume":"47","author":"Kaluzny","year":"2021","journal-title":"J. Cataract Refract. Surg."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"98","DOI":"10.5455\/aim.2020.28.98-102","article-title":"Changes in the higher order ocular aberrations and central corneal thickness after T-PRK and Fs-LASIK","volume":"28","author":"Biscevic","year":"2020","journal-title":"Acta Inform. Medica"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"180","DOI":"10.5455\/aim.2020.28.180-184","article-title":"Vector analysis of visual acuity and refractive outcomes of astigmatic corrections after T-PRK and Fs-LASIK","volume":"28","author":"Biscevic","year":"2020","journal-title":"Acta Inform. Medica"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/20\/6182\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:15:03Z","timestamp":1760112903000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/20\/6182"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,17]]},"references-count":30,"journal-issue":{"issue":"20","published-online":{"date-parts":[[2024,10]]}},"alternative-id":["jcm13206182"],"URL":"https:\/\/doi.org\/10.3390\/jcm13206182","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,10,17]]}}}