Photorefractive keratectomy following penetrating keratoplasty

We present 3 eyes that underwent photorefractive keratectomy (PRK) for residual myopia after penetrating keratoplasty, and 1 eye that was treated for recurrent granular dystrophy and myopia following penetrating keratoplasty. The 3 refractive eyes experienced improvements in visual acuity and refractive error through 3 months postoperative, but exhibited regression of effect after 6 months postoperative. One eye also exhibited substantial corneal haze at three months postoperative that was not responsive to steroid retreatment. The eye with granular dystrophy obtained symptomatic relief as well as improvement in vision. We tentatively conclude that the corneal transplant reacts to photorefractive keratectomy in much the same way as a normal cornea. Eyes with substantial degrees of post-graft myopia exhibit regression of refractive effect, much like high myopes following primary photorefractive keratectomy. Photorefractive was unable to prevent the recurrence of granular dystrophy in the transplanted tissue. The eyes reported here achieved only modest long-term visual and refractive improvements.