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Intraepithelial photorefractive keratectomy for regression after laser in situ keratomileusis
J L Güell1, C P Lohmann, F A Malecaze
1Instituto de Microcirurgia Ocular, Unidad de Cornea y Cirurgia Refractiva, Barcelona, Spain.
Purpose:
To propose a refractive procedure, intraepithelial photorefractive keratectomy (IE-PRK), to treat regression after laser in situ keratomileusis (LASIK).
Setting:
IMO Instituto de Microcirugîa Ocular de Barcelona, Cornea and Refractive Surgery Unit, Autonoma University of Barcelona, Barcelona, Spain; Vall d'Hebron Hospital, Department of Ophthalmology, INSERM, University Hospital, Toulouse, France.
Methods:
This open but uncontrolled prospective pilot study assessed the efficacy, predictability, and stability of IE-PRK in 21 eyes of 21 patients who had previous LASIK for myopia or myopic astigmatism with a mean spherical equivalent (SE) refraction of -9.80 diopters +/- 2.95 (SD). After LASIK, the eyes regressed to a mean of -1.93 +/- 0.82 D. They were retreated with IE-PRK, in which a photoablation was performed directly in the epithelium without damage to Bowman's membrane. Follow-up was up to 1 year.
Results:
Eight of the 21 eyes (38%) were emmetropic at 6 months and 11 (52.4%) had a refraction between -0.50 and +0.50 D. Refraction was stable from the second week to the first year, with no significant differences among the mean SEs at 10 days, 6 weeks, and 6 and 12 months.
Conclusion:
The preliminary results of this small series indicate that IE-PRK appears to be safe, especially in selected cases; 1 line of lost best spectacle-corrected visual acuity occurred in 5% of eyes.