Refractive keratotomy after photorefractive keratectomy

Area of Science:

• Ophthalmology
• Refractive Surgery
• Corneal Surgery

Background:

• Residual refractive errors like myopia and astigmatism can occur after photorefractive keratectomy (PRK).
• Existing surgical options for post-PRK correction include refractive keratotomy, LASIK, repeat PRK, and PARK.
• The safety and efficacy of refractive keratotomy for post-PRK correction require further investigation.

Purpose of the Study:

• To evaluate the safety and efficacy of refractive keratotomy in correcting residual myopia and/or astigmatism following prior PRK.
• To determine if current refractive keratotomy nomograms are suitable for eyes previously treated with PRK.

Main Methods:

• Ten eyes from 9 patients with residual refractive errors after PRK underwent refractive keratotomy.
• The Lindstrom nomogram was utilized for the refractive keratotomy procedure.
• All initial PRK procedures were performed using the VISX 20/20 excimer laser system by a single surgeon.

Main Results:

• Uncorrected visual acuity of 20/40 or better was achieved in all but one eye.
• One eye experienced myopic astigmatic regression and significant corneal haze post-PRK, necessitating refractive keratotomy.
• This same patient was the only one to experience a two-line loss in spectacle-corrected visual acuity due to corneal haze.

Conclusions:

• Refractive keratotomy is a viable option for reducing residual myopia and astigmatism after PRK.
• The findings suggest that established refractive keratotomy nomograms can be safely applied to eyes with a history of PRK.
• Refractive keratotomy offers a predictable solution for managing refractive surprises post-PRK.