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Updated: Jul 9, 2025
Author Spotlight: Advancements in Refractive Surgical Correction for Presbyopia and Exploring Postoperative Visual Acuity
Published on: September 20, 2024
Photorefractive keratectomy in flat, normal, and steep corneas
Eliya Levinger1, Roee Arnon, Joseph Pikkel
1From the Department of Ophthalmology, Tel Aviv Medical Center affiliated with the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel (Levinger); Department of Ophthalmology, Assuta-Samson Ashdod Hospital affiliated with the Faculty of Medicine, Ben Gurion University, Beer-Sheva, Israel (Arnon, Pikkel, Yahalomi); Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel (Mimouni); Bruce and Ruth Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel (Mimouni); Care-Vision Laser Centers, Tel-Aviv, Israel (Sela, Munzer, Mimouni).
Photorefractive keratectomy (PRK) outcomes are similar across corneas of varying steepness. Wavefront-optimized PRK is safe and effective for flat, normal, and steep corneas, demonstrating comparable visual acuity and refractive results.
Area of Science:
- Ophthalmology
- Refractive Surgery
- Corneal Surgery
Background:
- Corneal steepness can influence refractive surgery outcomes.
- Understanding the impact of corneal topography is crucial for optimizing surgical results.
- Wavefront-optimized photorefractive keratectomy (PRK) is a common procedure for myopia correction.
Purpose of the Study:
- To compare the outcomes of wavefront-optimized myopic PRK in patients with different corneal steepness.
- To evaluate the safety and efficacy of PRK across a spectrum of corneal curvatures.
Main Methods:
- A retrospective chart review included patients who underwent wavefront-optimized myopic PRK.
- Patients were categorized into three groups based on corneal steepness: flat (<42 D), normal (42-46 D), and steep (>46 D).
- One-to-one matching ensured baseline similarity in age, preoperative visual acuity, and refractive error between groups. Postoperative outcomes included visual acuity, safety and efficacy indices, and refractive outcomes.
Main Results:
- No significant differences were observed in safety index, efficacy index, corrected distance visual acuity (CDVA), or uncorrected distance visual acuity (UDVA) between the flat, normal, and steep cornea groups.
- Visual outcomes, including spherical equivalence (SEQ) and cylinder, were comparable across all three corneal steepness groups.
- Specifically, percentages of eyes within 0.50 D and 1.00 D of target SEQ and cylinder were statistically similar between groups.
Conclusions:
- Wavefront-optimized myopic PRK yields comparable visual and refractive outcomes regardless of corneal steepness.
- The procedure is demonstrated to be safe and effective for patients with flat, normal, and steep corneas.
- Corneal steepness is not a limiting factor for successful wavefront-optimized PRK.
