Refractive keratotomy after photorefractive keratectomy.

Abstract

The current surgical procedures available for the treatment of residual myopia and/or astigmatism after photorefractive keratectomy (PRK) include refractive keratotomy, laser in situ keratomileusis (LASIK), repeat PRK, or photorefractive astigmatic keratectomy (PARK). In this study, we investigate the safety and efficacy of refractive keratotomy for the correction of residual myopia and/or astigmatism after PRK. Ten eyes of 9 patients underwent refractive keratotomy after excimer laser photorefractive keratectomy using the Lindstrom nomogram. PRK procedures were performed using the VISX 20/20 system by one surgeon. All eyes except one obtained an uncorrected visual acuity of 20/40 or better. One eye developed significant haze following PRK with myopic astigmatic regression and underwent refractive keratotomy to correct the residual refractive error. This patient was also the only patient who lost 2 lines of spectacle-corrected visual acuity secondary to corneal haze. This study demonstrates that refractive keratotomy can reduce residual astigmatism and myopia that may be present following excimer laser photorefractive keratectomy. Our results suggest there is no need to change the refractive keratotomy nomograms for eyes that have previously undergone PRK.