We aimed to evaluate and compare the level of pain and the epithelial defect healing rate between the CXL and PRK treated groups.

Sixty eight patients were enrolled from April 2014 to May 2015. The PRK group consisted of 34 patients with simple refractory errors whereas the CXL group included another 34 patients with clinical keratoconus. Patients in both groups were examined and compared regarding the level of pain (based on the visual analogue scale (VAS), verbal rating scale (VRS) and Wong-Baker FACES pain rating scale, and epithelial defect (ED) size immediately after surgery and also 6 hours, one, three and seven days after the surgical procedure

Mean age of patients in the PRK and CXL group was 29±1.19 and 28±0.73 years, respectively. ED size in the CXL group was significantly lower than the PRK group in both eyes on the first post-operative day (p<0.001). The amount of pain experienced by the patient was statistically higher in CXL group in comparison with PRK group ( p= 0.04 and p= 0.019) based on VAS and VRS, respectively. In addition, passing time after surgery attributed to decrease in pain ( p< 0.001) for both VAS and VRS. No intra- or postoperative adverse events were observed during follow up.

Our findings showed a significantly faster ED healing rate on the first post-op day in the CXL group compared to the PRK group. However, the level of pain experienced was greater in the CXL group.It shows that post-surgical pain might be influenced by other factors than ED.