Outcomes of Photorefractive Keratectomy After Corneal Graft: Brief Review

The purpose of this brief review is to analyze the outcomes of customized photorefractive keratectomy in the correction of refractive errors and irregular astigmatism after corneal graft surgery.

Two reviewers (M.S.K. and J.L.A.) independently performed a literature search in the MEDLINE/PubMed database, Google Scholar, and ResearchGate from January 2001 to October 2023. To analyze the efficacy, safety, and predictability of the procedure, primary outcomes such as mean change in uncorrected distance visual acuity, corrected distance visual acuity, and root mean square value (RMS) of higher order aberrations were studied. The complications and adverse reactions were analyzed to predict the safety of this procedure.

We identified those studies where customized (topography guided/wavefront guided) photograph refractive keratectomy was performed in patients with postkeratoplasty. Significant change in uncorrected distance visual acuity, corrected distance visual acuity, RMS of higher order aberrations, refractive cylinder, and mean spherical equivalent were observed. Corneal haze was the most common complication documented; however, this was more commonly documented by authors who have not used Mitomycin C in their patients.

We found out that customized photograph refractive keratectomy is a safe, effective, and predictable method of treatment for refractive error and irregular astigmatism after keratoplasty.