Twelve-year Follow-up of Photorefractive Keratectomy for Low to Moderate Myopia

Abstract

To evaluate long-term safety and stability in a group of myopic patients who underwent photorefractive keratectomy (PRK) > or =12 years ago. Myopic PRK was performed on 120 eyes of 80 patients using the Summit UV200 excimer laser with a 5-mm ablation zone. Of the original group, most of whom were followed for > or =2 years (mean 2.6 +/- 1.7 years), 34 patients (58 eyes) returned at 12 years (mean 12.7 +/- 0.79 years) and had refractive stability, refractive predictability, best spectacle-corrected visual acuity (BSCVA), corneal haze, and subjective patient symptoms, such as glare/halos, recorded. Preoperative mean refractive spherical equivalent (MRSE) ranged from -1.75 to -7.25 diopters (D) and astigmatism from 0.00 to 1.50 D. All eyes underwent a change in manifest refraction over 12 years. At 2 years, MRSE was -0.27 +/- 0.55 D and at 12 years was -0.58 +/- 0.72 D. In 87.9% of eyes, the level of preoperative BSCVA was maintained or improved, whereas 34.5% of eyes gained one line, and 12.1% lost one line of BSCVA. Uncorrected visual acuity > or = 20/20 was noted in 67% of eyes, whereas 62.1% were within +/- 0.50 D of emmetropia. Trace haze was noted in 17.2% of eyes at 12 years. One patient had a rhegmatogenous retinal detachment, but this was unlikely due to the PRK procedure. With respect to the small optical zone, 14 (41.1%) patients had night visual problems, particularly halos, which were severe in 2.7%. All patients questioned stated they would have the procedure done again. Photorefractive keratectomy with the Summit UV200 excimer laser effectively reduced myopia and showed good refractive stability from year 2 to 12 with good patient satisfaction.