title: Photorefractive keratectomy with mitomycin-C after corneal transplantation for keratoconus.
abstract: OBJECTIVE
  To evaluate the efficacy of photorefractive keratectomy (PRK) for residual refractive error after penetrating keratoplasty (PKP) for keratoconus.
  
  
  METHODS
  Private ophthalmic clinic.
  
  
  METHODS
  Case series.
  
  
  METHODS
  Consecutive patients who had PRK augmented with topical mitomycin-C (MMC) after PKP for keratoconus were retrospectively reviewed. Patients were divided into a a low cylinder group (refractive cylinder ≤ 6.00 D) and a high cylinder group (refractive cylinder >6.00 D). Visual acuity, refraction, and keratometry were analyzed preoperatively and 1, 3, 6, and 12 months postoperatively.
  
  
  RESULTS
  The study comprised 47 eyes (41 patients). The spherical equivalent (SE) decreased from -4.24 D ± 3.23 (SD) preoperatively to -0.71 ± 1.03 D 12 months postoperatively in the low cylinder group and from -4.19 ± 3.54 D to -2.45 ± 3.42 D, respectively, in the high cylinder group. The refractive cylinder decreased from -4.27 ± 1.4 D to -1.71 ± 1.55 D, respectively, in the low cylinder group and from -7.78 ± 1.21 D to -4.6 ± 2.54 D, respectively, in the high cylinder group. By the last follow-up, 8.3% of patients had lost 2 lines of corrected distance visual acuity. There were no cases of corneal haze greater than 2+ or of graft rejection.
  
  
  CONCLUSIONS
  Penetrating keratoplasty with adjunctive MMC decreased several refractive variables in patients with previous PKP. These results compare well with those in the published literature and suggest PRK is as effective as, and probably safer than, laser in situ keratomileusis in treating refractive error in these cases.
  
  
  BACKGROUND
  No author has financial or proprietary interests in any material or method mentioned.
authors.affiliation: Vision Eye Institute, Chatswood, Sydney, Australia. christopher.hodge@vgaustralia.com
authors.forename: Chris
authors.initials: C
authors.lastname: Hodge
authors.forename: Gerard
authors.initials: G
authors.lastname: Sutton
authors.forename: Michael
authors.initials: M
authors.lastname: Lawless
authors.forename: Chris
authors.initials: C
authors.lastname: Rogers
mesh_terms: D000328:Adult; D000368:Aged; D000477:Alkylating Agents / Q000008:administration & dosage*; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007640:Keratoconus / Q000503:physiopathology / Q000601:surgery*; D015948:Keratoplasty, Penetrating; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage*; D018903:Photorefractive Keratectomy; D011182:Postoperative Care; D012029:Refraction, Ocular / Q000502:physiology; D054140:Refractive Surgical Procedures; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult
chemical_list: D000477:Alkylating Agents; D016685:Mitomycin