Photorefractive keratectomy for astigmatism with the Meditec MEL 60 laser.
OBJECTIVE
To evaluate the results of photorefractive keratectomy (PRK) in eyes treated with astigmatic refractive errors.


METHODS
Nine hundred forty eyes were treated with the Aesculap Meditec MEL 60 ArF excimer laser. Treatment groups were: Group 1 (n=746) eyes with compound myopic astigmatism, Group 2 (n=104) eyes with compound hyperopic astigmatism, Group 3 (n=75) eyes treated for mixed astigmatism, and Group 4 (n=15) eyes with simple myopic astigmatism (negative cylinder).


RESULTS
In Group 1, the preoperative spherical equivalent refraction of -6.10 D with an average of -1.50 D cylinder decreased to -0.95 D with -0.13 D cylinder; uncorrected visual acuity (UCVA) of 20/40 or better was achieved in 86% (642/746 eyes); 20/20 or better in 58% (433/746 eyes); 0.8% (6/746 eyes) lost two lines of spectacle-corrected visual acuity (SCVA); 74% (552/746 eyes) were within +/-0.50 D and 93% (694/746 eyes) were within +/-1.00 D of target refraction. In Group 2, preoperative mean +4.57 D spherical equivalent refraction with an average of +1.57 D cylinder decreased to +1.13 D with +0.38 D cylinder; UCVA of 20/40 or better was achieved in 84% (87/104 eyes); 20/20 or better in 46% (48/104 eyes); 14,4% (15/104 eyes) lost two or more lines of SCVA; 52% (54/104 eyes) were within +/-0.50 D and 82% (85/104 eyes) were within +/-1.00 D of target refraction. In Group 3, mean preoperative -4.20 D cylinder and +3.00 D spherical equivalent refraction decreased to -0.50 D cylinder and -0.50 D spherical equivalent refraction; UCVA of 20/40 or better was achieved in 83% (62/75 eyes); 20/20 or better in 32% (24/75 eyes); 13.3% (10/75 eyes) lost two or more lines of SCVA. In Group 4, mean preoperative -3.98 D cylinder decreased to -0.62 D cylinder; UCVA of 20/40 or better was achieved in 60% (9/15 eyes); none of the eyes achieved 20/20 or better; SCVA remained stable in 6.6% (1/15 eyes) and decreased two or more lines in 20.0% (3/15 eyes); 20% (3/15 eyes) were within +/-0.50 D and 53.3% (8/15 eyes) were within +/-1.00 D of target refraction.


CONCLUSIONS
PRK with the Meditec MEL 60 laser produced the best results in eyes with compound myopic astigmatism (Group 1). In all other groups, results were less predictable.
Nagy
Z Z
ZZ
1st Department of Ophthalmology, Semmelweis Medical University, Budapest, Hungary.
Krueger
R R
RR
Süveges
I
I
D000328:Adult; D001251:Astigmatism / Q000601:surgery*; D019781:Corneal Topography; D019466:Glare; D006801:Humans; D006956:Hyperopia / Q000601:surgery*; D007429:Intraocular Pressure; D007431:Intraoperative Complications; D054018:Lasers, Excimer; D009216:Myopia / Q000601:surgery*; D017060:Patient Satisfaction; D018903:Photorefractive Keratectomy; D011183:Postoperative Complications; D012029:Refraction, Ocular; D016896:Treatment Outcome; D014792:Visual Acuity