title: Corneal wavefront-guided photorefractive keratectomy with mitomycin-C for hyperopia after radial keratotomy: two-year follow-up.
abstract: OBJECTIVE
  To assess corneal wavefront-guided photorefractive keratectomy (PRK) to correct hyperopia after radial keratotomy (RK).
  
  
  METHODS
  Sadalla Amin Ghanem Eye Hospital, Joinville, Santa Catarina, Brazil.
  
  
  METHODS
  Case series.
  
  
  METHODS
  Excimer laser corneal wavefront-guided PRK with intraoperative mitomycin-C (MMC) 0.02% was performed. Main outcome measures were uncorrected (UDVA) and corrected (CDVA) distance visual acuities, spherical equivalent (SE), corneal aberrations, and haze.
  
  
  RESULTS
  The mean time between RK and PRK in the 61 eyes (39 patients) was 18.8 years ± 3.8 (SD). Before PRK, the mean SE was +4.17 ± 1.97 diopters (D); the mean astigmatism, -1.39 ± 1.04 D; and the mean CDVA, 0.161 ± 0.137 logMAR. At 24 months, the mean values were 0.14 ± 0.99 D (P<.001), -1.19 ± 1.02 D (P=.627), and 0.072 ± 0.094 logMAR (P<.001), respectively; the mean UDVA was 0.265 ± 0.196 (P<.001). The UDVA was 20/25 or better in 37.7% of eyes and 20/40 or better in 68.9%. The CDVA improved by 1 or more lines in 62.3% of eyes. Two eyes (3.3%) lost 2 or more lines, 1 due to corneal ectasia. Thirty eyes (49.2%) were within ± 0.50 D of intended SE and 45 (73.8%) were within ± 1.00 D. From 6 to 24 months, the mean SE regression was +0.39 D (P<.05). A significant decrease in coma, trefoil, and spherical aberration occurred. Three eyes developed peripheral haze more than grade 1.
  
  
  CONCLUSIONS
  Corneal wavefront-guided PRK with MMC for hyperopia after RK significantly improved UDVA, CDVA, and higher-order corneal aberrations with a low incidence of visually significant corneal haze.
authors.affiliation: Sadalla Amin Ghanem Eye Hospital, Joinville, Brazil. ramonghanem@gmail.com
authors.forename: Ramon C
authors.initials: RC
authors.lastname: Ghanem
authors.forename: Vinícius C
authors.initials: VC
authors.lastname: Ghanem
authors.forename: Emir A
authors.initials: EA
authors.lastname: Ghanem
authors.forename: Newton
authors.initials: N
authors.lastname: Kara-José
mesh_terms: D000328:Adult; D000368:Aged; D000477:Alkylating Agents / Q000008:administration & dosage*; D003131:Combined Modality Therapy; D057108:Corneal Wavefront Aberration / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006956:Hyperopia / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D007646:Keratotomy, Radial; D054018:Lasers, Excimer; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage*; D018903:Photorefractive Keratectomy; D011183:Postoperative Complications; D011446:Prospective Studies; D012029:Refraction, Ocular / Q000502:physiology; D014792:Visual Acuity / Q000502:physiology
chemical_list: D000477:Alkylating Agents; D016685:Mitomycin