Wavefront-Guided Photorefractive Keratectomy in Complicated Patients with History of Radial Keratotomy: A Clinical Trial

Document Type : Original Article(s)

Authors

1 Professor, Department of Ophthalmology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

2 Resident, Department of Ophthalmology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

3 Assistant Professor, Department of ophthalmology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

4 Student of Medicine, Isfahan Medical Students Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

Abstract

Background: Notwithstanding the fact that Radial keratotomy (RK) is now a neglected surgical method, patients and ophthalmologists are still dealing with its following complications such as hyperopic shift. This study was sought to assess the results and benefits of Photorefractive keratectomy (PRK) in complicated patients who had RK procedure in their clinical history.Methods: This non-controlled clinical trial was carried out on 20 eyes pertaining to 17 patients with history of RK and presenting with significant refractive problems. All patients undergone Wavefront-guided (WG) PRK with Mitomycin-C and were followed for at least three months. Uncorrected distance visual acuity (UDVA), Corrected distance visual acuity (CDVA), total aberration, high order (HO) aberration and complications were compared between the status of patients before and after the procedure.Finding: UDVA was averagely improved about 3 lines (P < 0.001). After the procedure 100% and 50% of subjects had visual acuity of ≥ 4.10 and ≥ 7.10, respectively, while; such frequencies prior to the procedure were about 55% and 0%, respectively. Moreover, 40% and 100% were at the idealistic refraction status of 1 D and 1.75 D, respectively. None of 20 subjects had decline of CDVA. Total aberrations were significantly decreased (P < 0.001) although changes of HO aberrations did not achieve significance level (P = 0.33) Three subjects manifested corneal opacity following PRK (two with grade II and one with grade I).  Conclusion: WG PRK has benefit in most of the cases and our current experience indicates the value of WG PRK in patients with history of RK. 

Keywords

References

  1. Waring GO, III, Lynn MJ, McDonnell PJ. Results of the prospective evaluation of radial keratotomy (PERK) study 10 years after surgery. Arch Ophthalmol 1994; 112(10): 1298-308.
  2. Deitz MR, Sanders DR, Raanan MG, DeLuca M. Long-term (5- to 12-year) follow-up of metal-blade radial keratotomy procedures. Arch Ophthalmol 1994; 112(5): 614-20.
  3. Munoz G, Albarran-Diego C, Sakla HF, Javaloy J. Femtosecond laser in situ keratomileusis for consecutive hyperopia after radial keratotomy. J Cataract Refract Surg 2007; 33(7): 1183-9.
  4. Oral D, Awwad ST, Seward MS, Bowman RW, McCulley JP, Cavanagh HD. Hyperopic laser in situ keratomileusis in eyes with previous radial keratotomy. J Cataract Refract Surg 2005; 31(8): 1561-8.
  5. Francesconi CM, Nose RA, Nose W. Hyperopic laser-assisted in situ keratomileusis for radial keratotomy induced hyperopia. Ophthalmology 2002; 109(3): 602-5.
  6. Clausse MA, Boutros G, Khanjian G, Wagner C, Garabet AL. A retrospective study of laser in situ keratomileusis after radial keratotomy. J Refract Surg 2001; 17(2 Suppl): S200-S201.
  7. Lipshitz I, Man O, Shemesh G, Lazar M, Loewenstein A. Laser in situ keratomileusis to correct hyperopic shift after radial keratotomy. J Cataract Refract Surg 2001; 27(2): 273-6.
  8. Attia WH, Alio JL, Artola A, Munoz G, Shalaby AM. Laser in situ keratomileusis for undercorrection and overcorrection after radial keratotomy. J Cataract Refract Surg 2001; 27(2): 267-72.
  9. Lyle WA, Jin GJ. Laser in situ keratomileusis for consecutive hyperopia after myopic LASIK and radial keratotomy. J Cataract Refract Surg 2003; 29(5): 879-88.
  10. Perente I, Utine CA, Cakir H, Yilmaz OF. Complicated flap creation with femtosecond laser after radial keratotomy. Cornea 2007; 26(9): 1138-40.
  11. Joyal H, Gregoire J, Faucher A. Photorefractive keratectomy to correct hyperopic shift after radial keratotomy. J Cataract Refract Surg 2003; 29(8): 1502-6.
  12. Nassaralla BA, McLeod SD, Nassaralla JJ. Prophylactic mitomycin C to inhibit corneal haze after photorefractive keratectomy for residual myopia following radial keratotomy. J Refract Surg 2007; 23(3): 226-32.
  13. Azar DT, Tuli S, Benson RA, Hardten DR. Photorefractive keratectomy for residual myopia after radial keratotomy. PRK After RK Study Group. J Cataract Refract Surg 1998; 24(3): 303-11.
  14. Maloney RK, Chan WK, Steinert R, Hersh P, OConnell M. A multicenter trial of photorefractive keratectomy for residual myopia after previous ocular surgery. Summit Therapeutic Refractive Study Group. Ophthalmology 1995; 102(7): 1042-52.
  15. Schallhorn SC, Farjo AA, Huang D, Boxer Wachler BS, Trattler WB, Tanzer DJ, et al. Wavefront-guided LASIK for the correction of primary myopia and astigmatism a report by the American Academy of Ophthalmology. Ophthalmology 2008; 115(7): 1249-61.
  16. Carones F, Vigo L, Scandola E, Vacchini L. Evaluation of the prophylactic use of mitomycin-C to inhibit haze formation after photorefractive keratectomy. J Cataract Refract Surg 2002; 28(12): 2088-95.
  17. Campos M, Lee M, McDonnell PJ. Ocular integrity after refractive surgery: effects of photorefractive keratectomy, phototherapeutic keratectomy, and radial keratotomy. Ophthalmic Surg 1992; 23(9): 598-602.
  18. Peacock LW, Slade SG, Martiz J, Chuang A, Yee RW. Ocular integrity after refractive procedures. Ophthalmology 1997; 104(7): 1079-83.
  19. Mastropasqua L, Nubile M, Ciancaglini M, Toto L, Ballone E. Prospective randomized comparison of wavefront-guided and conventional photo-refractive keratectomy for myopia with the meditec MEL 70 laser. J Refract Surg 2004; 20(5): 422-31.
  20. Artola A, Ayala MJ, Ruiz-Moreno JM, De La HF, Alio JL. Rupture of radial keratotomy incisions by blunt trauma 6 years after combined photorefractive keratectomy/radial keratotomy. J Refract Surg 2003; 19(4): 460-2.
Journal of Isfahan Medical School
Volume 29, Issue 141 - Serial Number 141
May and June 2011
Pages 657-664

Files

History

  • Receive Date: 21 June 2011
  • Revise Date: 27 May 2024
  • Accept Date: 06 April 2022

Share

How to cite

Statistics