Outcomes of Photorefractive Keratectomy in First-Degree Relatives of Patients With Keratoconus

The aim of this study was to evaluate the safety and efficacy of photorefractive keratectomy (PRK) for treating myopic astigmatism in first-degree relatives of patients with keratoconus.

This retrospective comparative interventional case series included 146 eyes of 73 consecutive first-degree relatives of patients with keratoconus (group 1). A control group consisted of 150 right eyes from 150 consecutive individuals with no family history of keratoconus (group 2). All eyes had normal clinical and topographic and tomographic examinations preoperatively and underwent PRK for myopic astigmatism. Postoperative visual acuity and refractive error were compared between the groups. Primary outcomes included efficacy, safety, and the occurrence of complications such as corneal ectasia.

The mean participant age was 27.0 ± 5.3 years in group 1 and 25.8 ± 4.9 years in group 2 ( P = 0.09), with follow-up periods of 65.2 ± 38.2 and 63.8 ± 46.8 months, respectively ( P = 0.81). The postoperative corrected distance visual acuity was 0.00 ± 0.02 and 0.01 ± 0.03 logarithm of the minimum angle of resolution in groups 1 and 2, respectively ( P = 0.26). The mean postoperative spherical equivalent refraction was -0.17 ± 0.37 diopters (D) in group 1 and -0.12 ± 0.33 D in group 2 ( P = 0.22), with a mean refractive astigmatism of -0.15 ± 0.28 D and -0.09 ± 0.31 D, respectively ( P = 0.11). The safety index was 1.01 ± 0.12 in group 1 and 1.00 ± 0.10 in group 2 ( P = 0.29) while the efficacy index was 0.94 ± 0.16 and 0.95 ± 0.16, respectively ( P = 0.98). No cases of corneal ectasia were observed in either group.

PRK is a safe and effective treatment for myopic refractive error in first-degree relatives of patients with keratoconus who have normal preoperative clinical and topographic/tomographic findings.