title: Three year results of photoastigmatic refractive keratectomy for mild and atypical keratoconus.
abstract: OBJECTIVE
  To evaluate the long-term effect of photoastigmatic refractive keratectomy (PARK) on mild keratoconus.
  
  
  METHODS
  Laser Unit, Ein Tal Eye Center, Tel Aviv, Israel.
  
  
  METHODS
  Eight eyes of 6 patients with stable compound myopic astigmatism and topography features of keratoconus were treated with a VISX Twenty-Twenty excimer laser. The laser beam slit width ranged between 4.8 and 5.0 mm according to the degree of cylinder. Preoperative slitlamp examination did not reveal significant thinning, ectasia, or scarring. Astigmatism ranged between -2.00 and -7.50 diopters and follow-up, between 36 and 48 months.
  
  
  RESULTS
  In 7 of 8 eyes, uncorrected visual acuity (UCVA) before PARK ranged between 6/30 and finger counting. After PARK, it ranged between 6/9(-) and 6/15, and patients could manage in most of their daily activities without using spectacles. In 2 eyes, the final UCVA was 6/15(-) and 6/15. In 1 eye, treatment failed to improve UCVA and corneal topography revealed progression of the keratoconus.
  
  
  CONCLUSIONS
  Photoastigmatic keratectomy was partially effective in eyes with mild stable keratoconus. However, the long-term results may be altered by progression of corneal thinning and ecstatic disease. In addition to the mild nature of the keratoconus, this is a small series and further studies are needed to confirm these results.
authors.affiliation: Ein Tal Eye Center, Tel Aviv, Israel.
authors.forename: I
authors.initials: I
authors.lastname: Kremer
authors.forename: Y
authors.initials: Y
authors.lastname: Shochot
authors.forename: A
authors.initials: A
authors.lastname: Kaplan
authors.forename: M
authors.initials: M
authors.lastname: Blumenthal
mesh_terms: D000328:Adult; D001251:Astigmatism / Q000473:pathology / Q000601:surgery*; D003315:Cornea / Q000473:pathology / Q000601:surgery*; D019781:Corneal Topography; D005500:Follow-Up Studies; D006801:Humans; D007640:Keratoconus / Q000473:pathology / Q000601:surgery*; D054018:Lasers, Excimer; D008875:Middle Aged; D009216:Myopia / Q000473:pathology / Q000601:surgery*; D018903:Photorefractive Keratectomy; D011446:Prospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity