[Current evaluation of myopia correction with the excimer laser].
Keratectomies with the excimer laser demonstrate extraordinarily smooth edges. Thermal and actinic side effects are negligible. Currently two techniques are in clinical use: the wide-field approach and the scanning-slit approach. A third one, the flying-spot approach is being tested in clinical studies. Postoperative refraction is mainly determined by the amount of correction. For corrections up to 6.0 D we found success rates of more than 90% and the refraction stabilizes during the first year after surgery. If the correction is higher, the success rate is decreased to 50% or less and the regression takes years. The complication rate is also dependent on the amount of correction: with corrections of more than 6.0 D it exceeds 1% and in corrections of 9.0 D and more, manifest corneal scars occur in more than 10% of the cases. Other complications are: eccentric ablation, IOP elevation due to steroid medication, and ptosis. Rheumatic diseases are absolutely contraindicated because of potential corneal melting ulcers, and subretinal neovascularization. In addition, corrections of more than 6.0 D are relatively contraindicated. More recent techniques like astigmatic PRK, LASIK, and hyperopic PRK are discussed.
Seiler
T
T
Universitäts-Augenklinik Dresden.
D005500:Follow-Up Studies; D006801:Humans; D054018:Lasers, Excimer; D009216:Myopia / Q000601:surgery*; D017060:Patient Satisfaction; D018903:Photorefractive Keratectomy; D011183:Postoperative Complications / Q000209:etiology*; D012029:Refraction, Ocular; D016896:Treatment Outcome