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Excimer laser surgery for keratoconus

J Mortensen1, K Carlsson, A Ohrström

  • 1Department of Ophthalmology, County Council Hospital, Jönköping, Sweden.

Journal of Cataract and Refractive Surgery
|July 31, 1998
PubMed
Summary
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Excimer laser photorefractive keratectomy (PRK) is safe for primary keratoconus, showing no increased risk. This treatment can improve vision and contact lens tolerance without hindering future corneal transplants.

Area of Science:

  • Ophthalmology
  • Corneal Surgery
  • Refractive Surgery

Background:

  • Keratoconus is a progressive eye condition causing corneal steepening.
  • Traditional treatments for keratoconus aim to improve vision and manage disease progression.
  • The safety and efficacy of excimer laser surgery for primary keratoconus require investigation.

Purpose of the Study:

  • To evaluate the safety and efficacy of excimer laser photorefractive keratectomy (PRK) in patients with primary keratoconus.
  • To determine if PRK for keratoconus poses an increased risk compared to standard procedures.
  • To assess the impact of PRK on visual acuity, contact lens tolerance, and future treatment options.

Main Methods:

  • Photorefractive keratectomy (PRK) using a VISX Twenty-Twenty B excimer laser (193 nm) was performed on 24 eyes of 23 patients with primary keratoconus.

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  • Treatments involved spherical, cylindrical, or combined ablations to reduce corneal steepness.
  • Patients were followed for an average of 22 months (range 6-46 months) to monitor outcomes.
  • Main Results:

    • 58% of patients (14 eyes) experienced improved visual acuity after PRK.
    • 46% of patients (11 eyes) could manage with spectacles, and 13% (3 eyes) achieved adequate visual function with contact lenses.
    • All treated corneas healed successfully, and no acceleration of keratoconus progression was observed.

    Conclusions:

    • Excimer laser PRK is not associated with increased risk when treating primary keratoconus.
    • PRK can enhance visual acuity and improve the ability to wear contact lenses in keratoconus patients.
    • The study suggests that excimer laser surgery does not impede subsequent corneal transplantation.