Intraepithelial photorefractive keratectomy for regression after laser in situ keratomileusis.
OBJECTIVE
To propose a refractive procedure, intraepithelial photorefractive keratectomy (IE-PRK), to treat regression after laser in situ keratomileusis (LASIK).


METHODS
IMO Instituto de Microcirugîa Ocular de Barcelona, Cornea and Refractive Surgery Unit, Autonoma University of Barcelona, Barcelona, Spain; Vall d'Hebron Hospital, Department of Ophthalmology, INSERM, University Hospital, Toulouse, France.


METHODS
This open but uncontrolled prospective pilot study assessed the efficacy, predictability, and stability of IE-PRK in 21 eyes of 21 patients who had previous LASIK for myopia or myopic astigmatism with a mean spherical equivalent (SE) refraction of -9.80 diopters +/- 2.95 (SD). After LASIK, the eyes regressed to a mean of -1.93 +/- 0.82 D. They were retreated with IE-PRK, in which a photoablation was performed directly in the epithelium without damage to Bowman's membrane. Follow-up was up to 1 year.


RESULTS
Eight of the 21 eyes (38%) were emmetropic at 6 months and 11 (52.4%) had a refraction between -0.50 and +0.50 D. Refraction was stable from the second week to the first year, with no significant differences among the mean SEs at 10 days, 6 weeks, and 6 and 12 months.


CONCLUSIONS
The preliminary results of this small series indicate that IE-PRK appears to be safe, especially in selected cases; 1 line of lost best spectacle-corrected visual acuity occurred in 5% of eyes.
D000328:Adult; D001251:Astigmatism / Q000209:etiology / Q000601:surgery*; D016039:Corneal Transplantation / Q000009:adverse effects*; D019573:Epithelium, Corneal / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects*; D054018:Lasers, Excimer; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000209:etiology / Q000601:surgery*; D018903:Photorefractive Keratectomy / Q000379:methods*; D010865:Pilot Projects; D011446:Prospective Studies; D012008:Recurrence; D012029:Refraction, Ocular; D012086:Reoperation; D012449:Safety; D016896:Treatment Outcome; D014792:Visual Acuity