Customized topography-guided photorefractive keratectomy with the MEL-70 platform and mitomycin C to correct hyperopia after radial keratotomy.
To evaluate topography-guided photorefractive keratectomy (PRK) for correcting hyperopia and astigmatism after radial keratotomy (RK).



Prospective study of 12 consecutive patients (19 eyes) who were treated with topography-guided PRK with 0.02% mitomycin C using an Asclepion-Meditec MEL-70 excimer laser with a 9.5-mm ablation zone. All eyes were operated by the same surgeon and followed for 1 year.



Thirteen eyes had complete epithelialization by day 7 and all eyes by day 10. At 1 year, uncorrected visual acuity was 20/25 or better in 42.1% of eyes and 20/40 or better in 68.4%. Preoperative mean spherical equivalent refraction was +3.80+/-2.47 diopters (D) and +0.24+/-2.36 D (P<.001) 1 year postoperative, with 47.4% of eyes being within +/-1.00 D and 73.7% within +/-2.00 D. Preoperative mean cylinder was -2.30+/-1.41 D and -0.62+/-0.73 D (P<.001) 1 year postoperative. At 1 year, 68.4% of eyes gained at least 1 line of best-spectacle corrected visual acuity, 36.8% gained more than 1 line, and only 2 eyes lost 1 line (one due to corneal haze). Three eyes developed central haze. Mean regression from 6 to 12 months in these 3 eyes was +1.83 D and in the remaining 16 eyes was -0.50 D.



Topography-guided PRK with mitomycin C was safe and reasonably effective for the treatment of hyperopia after RK.
Ghanem
Ramon C
RC
Sadalla Amin Ghanem Eye Hospital, Joinville, SC, Brazil. ramonghanem@gmail.com
Ghanem
Vinicius C
VC
de Souza
Denise C
DC
Kara-José
Newton
N
Ghanem
Emir A
EA
D000328:Adult; D000477:Alkylating Agents / Q000008:administration & dosage*; D001251:Astigmatism / Q000209:etiology / Q000601:surgery; D003131:Combined Modality Therapy; D019781:Corneal Topography / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006956:Hyperopia / Q000209:etiology / Q000601:surgery*; D007431:Intraoperative Complications; D007646:Keratotomy, Radial / Q000009:adverse effects*; D054018:Lasers, Excimer / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage*; D018903:Photorefractive Keratectomy / Q000379:methods*; D011183:Postoperative Complications; D011446:Prospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology
D000477:Alkylating Agents; D016685:Mitomycin