title: Photorefractive keratectomy for the correction of residual refractive error with Intacs intrastromal corneal ring segments in place.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of photorefractive keratectomy (PRK) for residual refractive errors in patients who had previous insertion of intrastromal corneal ring segments (Intacs, Addition Technology, Inc.) for treatment of low myopia.
  
  
  METHODS
  Shiley Eye Center, University of California San Diego, La Jolla, California, USA.
  
  
  METHODS
  This retrospective case series comprised patients who had Intacs segment implantation and subsequently developed myopic regression. Eight eyes of 5 patients had PRK over the Intacs in situ for the correction of the residual refractive error.
  
  
  RESULTS
  Six (75%) of the 8 eyes had plano refraction with 20/20 or better uncorrected visual acuity (UCVA) 1 month after PRK enhancement. Three months postoperatively, all eyes had plano refraction with 20/20 or better acuity. At the last follow-up examination (up to 2 years), all eyes had near plano vision (20/10 to 20/25). The corneal surface epithelium in all eyes healed in 3 to 5 days. One patient had subepithelial haze in both eyes, which resolved with epithelial scraping with mitomycin-C (MMC) application and a phototherapeutic keratectomy enhancement.
  
  
  CONCLUSIONS
  This small series showed that PRK can be used to treat residual refractive error after Intacs insertion. The UCVA was 20/25 or better in all cases after PRK enhancement. The incidence of post-PRK haze in this series of patients was high; topical MMC might be used in future cases to mitigate the problem.
authors.affiliation: Shiley Eye Center, University of California San Diego, La Jolla, California 92093-0946, USA.
authors.forename: Bryan U
authors.initials: BU
authors.lastname: Tan
authors.forename: Tracy L
authors.initials: TL
authors.lastname: Purcell
authors.forename: Aniruddha
authors.initials: A
authors.lastname: Nalgirkar
authors.forename: Michael P
authors.initials: MP
authors.lastname: Ehrenhaus
authors.forename: Luis F
authors.initials: LF
authors.lastname: Torres
authors.forename: David J
authors.initials: DJ
authors.lastname: Schanzlin
mesh_terms: D000328:Adult; D001672:Biocompatible Materials; D003319:Corneal Stroma / 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; D019904:Polymethyl Methacrylate; D019736:Prostheses and Implants; D019919:Prosthesis Implantation; D012029:Refraction, Ocular; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity; D014945:Wound Healing
chemical_list: D001672:Biocompatible Materials; D019904:Polymethyl Methacrylate