Corneal wavefront-guided photorefractive keratectomy with mitomycin-C for hyperopia after radial keratotomy: two-year follow-up.

Abstract

PURPOSE:

To assess corneal wavefront-guided photorefractive keratectomy (PRK) to correct hyperopia after radial keratotomy (RK).

SETTING:

Sadalla Amin Ghanem Eye Hospital, Joinville, Santa Catarina, Brazil.

DESIGN:

Case series.

METHODS:

Excimer laser corneal wavefront-guided PRK with intraoperative mitomycin-C (MMC) 0.02% was performed. Main outcome measures were uncorrected (UDVA) and corrected (CDVA) distance visual acuities, spherical equivalent (SE), corneal aberrations, and haze.

RESULTS:

The mean time between RK and PRK in the 61 eyes (39 patients) was 18.8 years ± 3.8 (SD). Before PRK, the mean SE was +4.17 ± 1.97 diopters (D); the mean astigmatism, -1.39 ± 1.04 D; and the mean CDVA, 0.161 ± 0.137 logMAR. At 24 months, the mean values were 0.14 ± 0.99 D (P<.001), -1.19 ± 1.02 D (P=.627), and 0.072 ± 0.094 logMAR (P<.001), respectively; the mean UDVA was 0.265 ± 0.196 (P<.001). The UDVA was 20/25 or better in 37.7% of eyes and 20/40 or better in 68.9%. The CDVA improved by 1 or more lines in 62.3% of eyes. Two eyes (3.3%) lost 2 or more lines, 1 due to corneal ectasia. Thirty eyes (49.2%) were within ± 0.50 D of intended SE and 45 (73.8%) were within ± 1.00 D. From 6 to 24 months, the mean SE regression was +0.39 D (P<.05). A significant decrease in coma, trefoil, and spherical aberration occurred. Three eyes developed peripheral haze more than grade 1.

CONCLUSION:

Corneal wavefront-guided PRK with MMC for hyperopia after RK significantly improved UDVA, CDVA, and higher-order corneal aberrations with a low incidence of visually significant corneal haze.

• Authors: Ramon C Ghanem, Vinícius C Ghanem, Emir A Ghanem, Newton Kara-José
• Journal: Journal of cataract and refractive surgery (J Cataract Refract Surg) Vol. 38 Issue 4 Pg. 595-606 (Apr 2012) ISSN: 1873-4502 [Electronic] United States
• PMID: 22440434 (Publication Type: Journal Article)
• Copyright: Copyright © 2012 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Chemical References

• Alkylating Agents
• Mitomycin

Topics

• Adult
• Aged
• Alkylating Agents (administration & dosage)
• Combined Modality Therapy
• Corneal Wavefront Aberration (etiology, physiopathology, surgery)
• Female
• Follow-Up Studies
• Humans
• Hyperopia (etiology, physiopathology, surgery)
• Keratotomy, Radial
• Lasers, Excimer
• Male
• Middle Aged
• Mitomycin (administration & dosage)
• Photorefractive Keratectomy
• Postoperative Complications
• Prospective Studies
• Refraction, Ocular (physiology)
• Visual Acuity (physiology)