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Photorefractive Keratectomy Outcomes Maintained Over Long Term: Presented at ARVO

By Ed Susman

FT. LAUDERDALE, F.L. -- May 1, 2006 -- A long-term study of photorefractive keratectomy to correct myopia indicates that patients undergoing this procedure maintain improved vision for at least 13 years, researchers said here at the Association for Research in Vision and Ophthalmology (ARVO) annual meeting.

"To our knowledge, this prospective study has the longest follow-up available on photorefractive keratectomy," said Graziano Bricola, MD, staff physician, University Eye Clinic of Genoa, University of Genoa, Genoa, Italy.

The researchers determined that the improvements seen after 3 months in patients treated with photorefractive keratectomy held up after 13 years "with no evidence of regression." They also found that ocular haze decreased with time and that patients recovered best-corrected vision acuity.

The study included 29 patients who had undergone the procedure in both eyes and 21 patients who had photorefractive keratectomy performed in just 1 eye -- or a total of 79 eyes. There were 32 men and 18 women among the 50 patients in the study.

Patients underwent the procedure with a Summit Technology UV200 Eximer laser. Patients were followed 1 day after surgery, then 3 to 6 days later, and once every 3 months for a year, every 6 months until year 2, and then every other year. Over the 13 years, 19 patients were lost to follow-up. The report was made on the basis of results in 49 eyes.

"No late complications were found in this study," Dr. Bricola said in the poster presentation April 30^th. By the end of the study 37 of the 39 corneas were clear; 2 eyes still showed subjective haze. The haze was described as halos seen by subjects during night driving or when looking at street lights at night, he said. The halos were more vivid to patients who underwent greater vision correction -- more than 6 diopters -- surgery.

"These results confirm other shorter studies and demonstrate the efficacy and safety of myopic photorefractive keratectomy," Dr. Bricola said.

The researchers said that 4 of the patients developed a temporary increase in ocular pressure about 1 to 3 months following the procedure. When the use of steroid was halted, the increase in pressure returned to normal values, Dr. Bricola said.

"At 13 years, no one had developed glaucoma or ocular hypertension," he reported.


[Presentation title: Long-Term Results of Photorefractive Keratectomy: A 13 Years Prospective Study. Abstract 538]

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