Laser in situ keratomileusis for residual myopia after photorefractive keratectomy.
OBJECTIVE
To evaluate the efficacy and safety of laser in situ keratomileusis (LASIK) for myopic regression and undercorrection after photorefractive keratectomy (PRK).


METHODS
The Eye Institute, Sydney, Australia.


METHODS
Fifty eyes of 32 patients were treated by LASIK for residual myopia following primary PRK. The mean spherical equivalent refraction (SEQ) was -2.92 diopters (D) +/- 1.57 (SD) (range -0.75 to -7.88 D). The mean refractive cylinder was 0.96 +/- 0.74 D (range 0 to 3.50 D). For analysis, the eyes were divided into 2 groups: those with 0 or low corneal haze (Group 1) and those with severe corneal haze (Group 2). In Group 1, the SEQ was -1.99 +/- 0.79 D (range -0.75 to -3.75 D) and in Group 2, -3.77 +/- 1.62 D (range -0.75 to -7.90 D). The procedure was performed using the Chiron Automated Corneal Shaper and the Summit Apex Plus laser. The mean interval between PRK and LASIK was 25 months (range 9 to 59 months). The following parameters were studied before and after LASIK retreatment: SEQ, mean refractive cylinder, uncorrected visual acuity (UCVA), and best corrected visual acuity (BCVA). Complications after LASIK retreatment were evaluated.


RESULTS
Six months after LASIK, the mean SEQ in all eyes was -0.65 +/- 0.86 D (range +1.50 to -3.35 D); 70.0% of eyes were within +/-1.00 D of emmetropia and the UCVA was 6/12 or better in 72.5%. The mean SEQ in Group 1 was -0.22 +/- 0.55 D (range -0.88 to -1.50 D) and in Group 2, -0.97+/- 0.92 D (range 0.12 to -3.25 D); the UCVA was 6/12 or better in 94.0% of eyes in Group 1 and in 56.0% in Group 2. No statistically significant between-group difference was found in lines of Snellen acuity lost or gained at 6 months. No eye lost more than 1 line of BCVA.


CONCLUSIONS
Laser in situ keratomileusis appears to be a safe, effective, and predictable procedure for treating eyes with 0 or low haze with residual myopia after PRK. It is less predictable in eyes with severe haze.
Comaish
Ian F
IF
The Eye Institute, Sydney, Australia.
Domniz
Yuval Y
YY
Lawless
Michael A
MA
Webber
Suzanne K
SK
Rogers
Christopher M
CM
Sutton
Gerard L
GL
D000328:Adult; D001251:Astigmatism / Q000601:surgery*; D003315:Cornea / Q000601:surgery*; D005260:Female; D006801:Humans; D020731:Keratomileusis, Laser In Situ; D054018:Lasers, Excimer; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000601:surgery*; D018903:Photorefractive Keratectomy; D012029:Refraction, Ocular; D012086:Reoperation; D012449:Safety; D016896:Treatment Outcome; D014792:Visual Acuity