Abstract
Purpose:To evaluate the efficacy of photorefractive keratectomy (PRK) using the advanced personalized treatment (APT) nomogram for correction of moderate to high astigmatism.Methods:This prospective interventional case series included 60 consecutive eyes of 30 patients undergoing wavefront-guided PRK (Zyoptix 217 Z100 excimer laser, Bausch & Lomb, Munich, Germany) using the APT nomogram and iris registration for myopic astigmatism. Mitomycin-C was applied intraoperatively in all eyes. Ophthalmic examination was performed preoperatively and 1, 3 and 6 months postoperatively.Results:Preoperatively, mean sphere was -1.68 ± 2.08 diopters (D), mean refractive astigmatism was -3.04 ± 1.05 D and mean spherical equivalent (SE) was -3.12 ± 1.77 D. Six months postoperatively, mean sphere was + 0.60 ± 0.64 D (P < 0.005), mean cylinder was -0.43 ± 0.46 D (P < 0.005) and mean SE was + 0.28 ± 0.48 D (P < 0.005). Hyperopic overcorrection (≥ +1.0 D) occurred in 3 (5%) eyes. Postoperatively, root mean square (RMS) of higher order aberrations (HOAs) was significantly increased (P = 0.041). RMS of spherical aberration (Z [4, 0]) showed no significant change after surgery (P = 0.972).Conclusion:Considering the acceptable residual refractive error, low rate of hyperopic overcorrection, acceptable uncorrected visual acuity, and low risk of postoperative corneal haze, PRK using the APT nomogram with iris registration and mitomycin-C use is a safe and effective modality for treatment of moderate to high astigmatism.
Highlights
IntroductionLaser refractive correction is nowadays a procedure of choice for surgical correction of spherical and cylindrical refractive errors; customized laser ablation
8% of operated patients who undergo laser refractive surgery for significant astigmatism need retreatment due to residual refractive error which can be caused by cyclotorsion of the eye from sitting position to the supine position
Refractive astigmatism was between ‐1.0 D and ‐4.0 D in 46 eyes (77%), and >‐4.0 D in 14 eyes (23%)
Summary
Laser refractive correction is nowadays a procedure of choice for surgical correction of spherical and cylindrical refractive errors; customized laser ablation. How to cite this article: Mohammadpour M, Hashemi H, Jabbarvand M, Rahmatnejad K, Sabet FA. PRK using APT for Astigmatism; Mohammadpour et al for the treatment of refractive errors especially myopia remains a challenge. It is estimated that for each 10‐degree misalignment in the astigmatic axis, there is 6% loss in correction effect.[1,2,3,4,5,6,7]
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