Myopic photorefractive keratectomy with the excimer laser. One-year follow-up

To evaluate the efficacy, predictability, and stability of myopic photorefractive keratectomy (PRK), the authors completed a 1-year follow-up study on a consecutive series of 26 sighted eyes undergoing this procedure. The results of this follow-up are presented. In addition, side effects and complications in another 255 sighted eyes with a follow-up of 3 months to 1 year are reported to judge the safety of the procedure. Twenty-four of 26 eyes (92%) were within +/- 1.0 diopter (D) of the intended final refraction (baseline, -1.4 to -9.25 D). Fifty-eight percent of the eyes were stable within +/- 0.25 D between 6 and 12 months. One year after surgery, none of the patients lost or gained more than one line of best corrected (spectacle) visual acuity. Uncorrected visual acuity improved to 20/40 or better in 96% of the eyes and to 20/20 or better in 48% of the eyes (not including the eyes that were intentionally undercorrected). However, visual acuity with glare decreased from 20/27 preoperatively to 20/31 after 1 year. Scarring occurred in 2.8% of the treated corneas. Risk factors for scarring include noncompliance with postoperative steroid medication, high myopic corrections, and high steroid responders (3.1%). Collagen vascular and other autoimmune diseases are a contraindication for PRK.