Factors Predicting Slow Visual Recovery Following Myopic Photorefractive Keratectomy

To identify factors predicting slow visual recovery following photorefractive keratectomy (PRK).

This retrospective study included consecutive patients who underwent PRK between January 2005 and December 2019 at Care Vision Laser Center, Tel Aviv, Israel. Myopic patients were divided into 2 groups according to whether they experienced normal recovery of visual acuity (within 60 days) or slow visual recovery (>60 days). Visual recovery was defined as achieving an efficacy index of 0.9 or greater. Efficacy index was calculated as postoperative uncorrected visual acuity/preoperative best corrected visual acuity. A comparison of baseline and intraoperative parameters was performed. Binary logistic regression was performed to identify potential predictors of slow visual recovery.

Overall, 4868 eyes were included. The mean age was 25.9 ± 7.7 years, and 53.9% were male. The slow visual recovery group (39.3%, n = 1911/4868) was older ( P < 0.001) and had greater refractive astigmatism ( P < 0.001) with a larger proportion of recent contact lens wearers ( P = 0.002). The slow recovery group had larger optic zone treatments ( P < 0.001), alcohol-assisted PRK (vs. transepithelial PRK) ( P < 0.001), and greater maximum ablation depth ( P < 0.001). In binary logistic regression, older age ( P < 0.001), higher refractive astigmatism ( P = 0.01), recent contact lens wear ( P = 0.01), greater optic zone treatment ( P = 0.001), and alcohol-assisted PRK ( P < 0.001) remained significant predictors of slow visual recovery.

Slow visual recovery was observed in ∼40% of patients following myopic PRK. Older age, greater refractive astigmatism, recent contact lens wear, greater optic zone treatment, and alcohol-assisted PRK were associated with slow visual recovery.