Faculty Collaboration Database

The safety and efficacy of photorefractive keratectomy after laser in situ keratomileusis. J Refract Surg 2005;21(4):353-8

Date

09/01/2005

Pubmed ID

16128332

DOI

10.3928/1081-597X-20050701-09

Scopus ID

2-s2.0-22644439733 (requires institutional sign-in at Scopus site)   34 Citations

Abstract

PURPOSE: To determine the safety and efficacy of performing photorefractive keratectomy (PRK) in corneas previously treated with laser in situ keratomileusis (LASIK) surgery.

METHODS: Fifteen eyes of 14 patients who had initially received LASIK for the treatment of myopia and compound myopic astigmatism were evaluated. Variables included existence of and/or type of flap complication associated with the original LASIK procedure, refractions before and after (3 and 6 months) PRK, uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), and the development of complications after PRK such as haze, scarring, double vision, or ghosting.

RESULTS: All 15 eyes were available for analysis at 6 months. Eleven eyes had experienced flap complications during the initial LASIK procedure and 4 eyes had experienced complications in the LASIK postoperative period. Characteristics prior to performing PRK included 11 myopic and 4 hyperopic eyes. By 6 months after PRK treatment, 87% of eyes had UCVA > or = 20/40, 53% had > or = 20/25, and 40% had > or = 20/20. All eyes had BSCVA of > or = 20/30, with 73% being > or = 20/20. No eye had lost 2 lines of BSCVA and only 1 eye lost 1 line of BSCVA. Sixty percent of eyes were within 1.0 diopters (D) of emmetropia, and 40% were within 0.5 D of emmetropia. A trend towards undercorrection and surgical induction of astigmatism as confirmed by vector analysis was noted. No eye developed significant haze or scarring.

CONCLUSIONS: Photorefractive keratectomy may be a safe procedure to perform in corneas previously treated with LASIK surgery. Results show good reduction of refractive error and improvement of UCVA and BSCVA. A significant undercorrection of astigmatism was attributed to surgically induced astigmatism. Further studies are necessary to determine the long-term safety and stability of outcomes.

Author List

Shaikh NM, Wee CE, Kaufman SC

MESH terms used to index this publication - Major topics in bold

Astigmatism
Cornea
Humans
Intraoperative Complications
Keratomileusis, Laser In Situ
Lasers, Excimer
Photorefractive Keratectomy
Postoperative Complications
Refractive Errors
Refractive Surgical Procedures
Reoperation
Safety
Treatment Outcome
Visual Acuity