title: Long-term results of multizone photorefractive keratectomy for myopia of -6.0 to -10.0 diopters.
abstract: OBJECTIVE
  To evaluate the 4 year refractive outcome of multizone photorefractive keratectomy (PRK) in eyes with high myopia.
  
  
  METHODS
  ++SSK Okmeydani Education Hospital, Eye Clinic, Türkiye Hospital, Okmeydani, Istanbul.
  
  
  METHODS
  Three ablation zones were used in 92 eyes of 48 patients whose refractive errors were between -6.0 and -10.0 diopters (D) (mean spherical equivalent -7.42 D +/- 1.25 [SD]). The zones were between 4.5 and 6.0 mm based on the thickness of the cornea and the refractive correction. After the epithelium healed, dexamethasone was applied 4 times a day during the first postoperative week and then fluorometholone was applied 4 times a day for a minimum of 4 weeks. If hyperopia was found post-PRK, the steroid dose was gradually tapered. The patients were examined 1 and 3 days postoperatively, 1, 2, and 4 weeks, every 3 months for the first year, and then every 6 months.
  
  
  RESULTS
  All patients were overcorrected in the first postoperative week. At 2 and 3 weeks, the mean manifest refraction was closer to emmetropia. At 6 months, the refraction was stable. The mean spherical equivalent was -0.10 D at the end of the first year, and stabilization continued for 4 years. After the third month, the haze regressed gradually without requiring treatment. In 1 patient, herpes simplex keratitis developed and healed in a short time with topical antiviral therapy. Nineteen eyes regressed more than -1.0 D, 4 eyes were overcorrected, 4 eyes had central islands (at 6 months), and 2 eyes were undercorrected. Two eyes were retreated for regression; 1 eye was retreated for undercorrection and 1 eye, for central island. An uncorrected visual acuity of 20/40 or better was achieved in 79.2% of eyes, and 73.9% were within +/-1. 0 D of the intended correction.
  
  
  CONCLUSIONS
  ++Photorefractive keratectomy was effective in treating high myopia between -6.0 and -10.0 D. The induced refractive changes stabilized between 6 and 9 months. In most patients, no significant regression was found after this period.
authors.affiliation: SSK Okmeydani Education Hospital, Eye Clinic, Istanbul Türkiye Hospital, Okmeydani, Istanbul, Turkey. keskinbora@superonline.com
authors.forename: H K
authors.initials: HK
authors.lastname: Keskinbora
mesh_terms: D000328:Adult; D003315:Cornea / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D054018:Lasers, Excimer; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000503:physiopathology / Q000601:surgery*; D018903:Photorefractive Keratectomy / Q000379:methods*; D011379:Prognosis; D012029:Refraction, Ocular; D012189:Retrospective Studies; D014792:Visual Acuity