Long-term outcomes of photorefractive keratectomy in eyes with previous epikeratophakia for keratoconus.
OBJECTIVE
To determine the long-term safety and effectiveness of photorefractive keratectomy (PRK) in the treatment of refractive errors after epikeratophakia (EP) for keratoconus.


METHODS
Ten patients (14 eyes) who had refractive errors after EP for keratoconus received PRK surgery. Uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), refractive error, corneal astigmatism, pachymetry, corneal topography, and complications were monitored.


RESULTS
Mean follow-up after PRK was 63.4 +/- 19.8 months. Mean spherical equivalent was -5.5 +/- 3.9 D before PRK, -0.9 +/- 0.5 D at 1 month after PRK, and -1.5 +/- 1.0 D at 3 years. Mean astigmatism was 4.2 +/- 2.1 D before PRK, 1.2 +/- 0.5 D at 1 month after PRK, and 1.5 +/- 0.6 D at 3 years. Thirteen (93%) eyes had an UCVA <20/40, and 12 (86%) had a BSCVA of 20/40 or better before PRK. At 1 year, the UCVA was 20/40 or better in 8 (57%) eyes, and the BSCVA was 20/40 or better in all eyes. Mean central corneal thickness was 749 +/- 35 microm before PRK and 621 +/- 56 mum at 3 years. During the follow-up period, haze (grade no more than 1.0) was observed in 2 eyes. No immune rejection episode or recurrent keratoconus was found.


CONCLUSIONS
PRK appears to be reliable and safe for the correction of residual ametropia after EP for keratoconus, and the visual acuity can remain stable after PRK for a long time.
State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Qingdao, China. lixinxie@public.qd.sd.cn
Lixin
L
Xie
Hua
H
Gao
Weiyun
W
Shi
D000293:Adolescent; D000328:Adult; D001251:Astigmatism / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D003315:Cornea / Q000503:physiopathology; D019781:Corneal Topography; D017391:Epikeratophakia / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D007640:Keratoconus / Q000503:physiopathology / Q000601:surgery*; D054018:Lasers, Excimer; D008297:Male; D009216:Myopia / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D018903:Photorefractive Keratectomy; D011183:Postoperative Complications; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology