Long-term efficacy and safty of photorefractive keratectomy in the pediatric population

Abstract

To use photorefractive keratectomy (PRK) for the treatment of myopia and hyperopia and to observe long term efficacy and safty in pediatric patients. In this prospective noncomparative interventional case series, 44 eyes of 22 patients with severe bilateral high refractive errors and 35 eyes of 35 patients with severe anisometropia who failed traditional therapy were treated with PRK. Patients were examined preoperatively and then postoperatively at month 1 and 6, year 1, and then annually. The main outcome measures were refractive stability, visual acuity, and corneal clarity. The average preoperative refractive error was −9.45 ± 4.16 D for the myopic patients and +6.32 ± 1.26D for the hyperopic patients. The mean spherical equivalent was −0.92 ± 1.64 D and 1.48 ± 0.51 D for the myopic and hyperopic group respectively at year one. The mean corneal haze score and percentage of eyes with corneal haze decreased from 0.9 to 0.5 and 64% to 25% in the myopic patients over three years of follow-up. In the patients that had measurable uncorrected visual acuity (UCVA) preoperatively, the UCVA improved from logMar 1.32 ± 0.57 to logMar 0.58 ± 0.31. Refraction was stable for up to 5 years of follow-up. This is pilot study. Large group studes are continuing. PRK is an effective and stable surgical alternative in children with refractive errors who are unable to tolerate traditional therapy.