title: Wavefront-guided photorefractive keratectomy in eyes with prior radial keratotomy: a multicenter study.
abstract: OBJECTIVE
  To investigate the outcomes of wavefront-guided photorefractive keratectomy (WG PRK) using prophylactic mitomycin C (MMC) in eyes that had previously undergone radial keratotomy (RK).
  
  
  METHODS
  Retrospective, observational, consecutive case series.
  
  
  METHODS
  Thirty-two eyes of 27 patients with previous RK that underwent WG PRK with MMC.
  
  
  METHODS
  The records were reviewed of consecutive RK patients whose eyes underwent WG PRK with MMC in 4 centers with postoperative follow-up of 6 months or longer (range, 6-21 months). Eyes were divided into myopic WG PRK and hyperopic WG PRK groups based on their preoperative spherical equivalent (SE). Preoperative best spectacle-corrected visual acuity (BSCVA) was compared with postoperative uncorrected visual acuity (UCVA) and BSCVA to ascertain efficacy and safety. Change in SE and attempted versus achieved SE were evaluated. Incidences of haze and other complications were recorded.
  
  
  METHODS
  Uncorrected visual acuity, BSCVA, SE, corneal haze, and other complications.
  
  
  RESULTS
  In the myopic WG PRK group (n = 9), UCVA improved by 3 lines on average (P = 0.015) with UCVA of > or =20/20 in 56% and > or =20/40 in 100% of eyes; 55% were within 0.5 diopter (D), and 100% were within 1 D of attempted refraction. In the hyperopic WG PRK group (n = 23), UCVA improved for 3 lines on average (P<0.001), with UCVA of > or =20/20 in 48% and > or =20/40 in 100% of eyes; 57% were within 0.5 D and 74% were within 1 D of attempted refraction. One eye lost 2 lines of BSCVA as a result of the development of mild to moderate haze, but recovered in 4 months. No eyes lost more than 2 lines of BSCVA. Six eyes (19%; 6/32) experienced the development of haze in the postoperative course, with mild to moderate haze in 1 eye and trace haze in the other 5 eyes. No other complications were noted.
  
  
  CONCLUSIONS
  Wavefront-guided PRK with MMC in eyes with prior RK improved the UCVA significantly and was safe over the short follow-up of this series. Although haze occurred, no eye suffered persistent visual loss of 2 or more lines.
  
  
  BACKGROUND
  Proprietary or commercial disclosure may be found after the references.
authors: Department of Ophthalmology, Baylor College of Medicine, 6565 Fannin Street, Houston, TX 77030, USA. dkoch@bcm.tmc.edu
authors: Douglas D
authors: DD
authors: Koch
authors: Robert
authors: R
authors: Maloney
authors: David R
authors: DR
authors: Hardten
authors: Steven
authors: S
authors: Dell
authors: Alex D
authors: AD
authors: Sweeney
authors: Li
authors: L
authors: Wang
mesh_terms: D000328:Adult; D003131:Combined Modality Therapy; D019781:Corneal Topography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006956:Hyperopia / Q000503:physiopathology / Q000601:surgery*; D007646:Keratotomy, Radial; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage*; D009216:Myopia / Q000503:physiopathology / Q000601:surgery*; D018903:Photorefractive Keratectomy; D011183:Postoperative Complications; D012029:Refraction, Ocular; D012086:Reoperation; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology*
chemical_list: D016685:Mitomycin