A 14-year Follow-up of Photorefractive Keratectomy

Abstract

To evaluate the long-term outcome of myopic photorefractive keratectomy (PRK). This prospective study included 31 patients (49 eyes) who underwent PRK between 1991 and 1993. A Summit UV200 excimer laser was used. Patients were divided into two groups--low myopia: preoperative < 6.00 diopters (D) (range: -1.50 to -5.75 D) (n = 19); and high myopia: preoperative > 6.00 D (range: -6.00 to -13.00 D) (n = 12). Long-term postoperative follow-up was every 2 years up to 14 years. Refraction, visual acuity, corneal status, and intraocular pressure (IOP) were evaluated. At 14 years, corneal topography and endothelial cell count were performed. At last follow-up, manifest refraction spherical equivalent (MRSE) for the low myopia group was -0.17 +/- 0.8, uncorrected visual acuity (UCVA) logMAR was -0.06 +/- 0.55, and best spectacle-corrected visual acuity (BSCVA) logMAR was 0.00 +/- 1.00. The high myopia group had a final MRSE of -0.67 +/- 1.4, UCVA logMAR -0.11 +/- 0.55, and BSCVA logMAR -0.03 +/- 1.00. At 14 years, BSCVA for most eyes was at least equal to preoperative BSCVA. In both groups, haze increased between 3 and 6 months, then declined in the first year. A temporary increase of IOP was seen in 4 eyes. Complications were minor haze (2 eyes), transient anisocoria (9 eyes), and intraepithelial hemosiderin deposits (4 eyes). No abnormalities in endothelial cell count or morphology, astigmatism, or ectasia were noted. Three patients reported night vision disturbance, but the majority of patients were satisfied with the outcome based on subjective questionnaire (low myopia group: 84%; high myopia group: 75%). Our study demonstrates the safety of myopic PRK.