Abstract
Purpose. To evaluate the accuracy, efficacy, stability, and safety of photorefractive keratectomy (PRK) enhancement using the Pulzar 213 nm solid-state laser (SSL) with adjunctive Mitomycin C in eyes previously treated with laser assisted in situ keratomileusis (LASIK) with residual error of refraction. Methods. This is a prospective noncomparative case series of 16 eyes of 12 patients who underwent PRK for residual refractive error after primary LASIK. Mitomycin C 0.02% was used after the PRK to prevent haze formation. Outcomes measured were pre- and postoperative manifest refraction spherical equivalent (MRSE), uncorrected (UDVA) and best-corrected distance visual acuity (CDVA), and slit lamp evidence of corneal complications. Results. The mean UDVA improved from 20/70 preoperatively to 20/30 postoperatively. The average gain in lines for the UDVA was 2.38. After six months of followup, the postoperative MRSE within 0.50 D in 56% (9) of eyes and 94% (15) eyes were within 1.0 diopters of the intended correction. No eyes developed haze all throughout the study. Conclusion. PRK enhancement with adjunctive use of Mitomycin C for the correction of residual error of refraction after LASIK using the Pulzar 213 nm solid-state laser is an accurate, effective, and safe procedure.
Highlights
Laser eye surgery has been accepted worldwide as a procedure to modify the shape of the cornea and correct myopia, hyperopia, astigmatism, and presbyopia
The cornea is a living tissue wherein its biomechanical and wound healing properties can restrict the predictability and stability of refractive surgery [1]. These factors contribute to the discrepancies between intended and achieved visual outcomes after laser-assisted in situ keratomileusis (LASIK), surface ablation, and other keratorefractive procedures leading to residual errors
The interval between primary LASIK to photorefractive keratectomy (PRK) enhancement procedure was between 4 weeks and 3 years
Summary
Laser eye surgery has been accepted worldwide as a procedure to modify the shape of the cornea and correct myopia, hyperopia, astigmatism, and presbyopia. The cornea is a living tissue wherein its biomechanical and wound healing properties can restrict the predictability and stability of refractive surgery [1]. These factors contribute to the discrepancies between intended and achieved visual outcomes after laser-assisted in situ keratomileusis (LASIK), surface ablation, and other keratorefractive procedures leading to residual errors. We chose to do photorefractive keratectomy (PRK) with adjunctive Mitomycin C using the 213 nm solid-state laser for the correction of residual error after LASIK. Photorefractive keratectomy (PRK) with adjunctive Mitomycin C has been shown to be safe and effective with the use of the 193 nm excimer lasers. The 213 nm solidstate laser allows more selective energy absorption by corneal collagen and less energy absorption by the surrounding water
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