No Abstract Available.
Lasers, Excimer* ; Myopia* ; Photorefractive Keratectomy*

Objective: To present the refractive and visual outcomes of refractive surgical treatment options in high myopia. Methods This was a retrospective review of patients diagnosed with high myopia (manifest refractive spherical equivalent [MRSE] ≥-6.00D) who underwent one of the following procedures: laser-in-situ keratomileusis (LASIK), photorefractive keratectomy (PRK), phakic IOL implantation with the Staar Implantable Collamer Lens (ICL), or Alcon Cachet Phakic IOL. Eyes with best corrected distance vision of less than 20/30 due to amblyopia or other eye pathologies were excluded.
Keratomileusis, Laser In Situ ; Photorefractive Keratectomy

PURPOSE: To assess the refractive outcomes in photorefractive keratectomy (PRK) of two eximer lasers: Broad beam and Flying spot laser. METHODS: We compared the refractive outcomes of 74 eyes (group I) treated with a VISX 20/20(excimer laser (VISX Inc. USA) using broad beam laser with those of 96 eyes (group II) treated with a Technolas 217 C-Lasik(TM) (Bausch and Lomb, USA) using flying spot laser. Each patients had been followed up for more than 6 months after surgery. RESULTS: Corneal astigmatism at preoperation were 1.25 +/- 0.62D in group I and 1.03 +/- 0.51D in group II and at postoperative 6 months, decreased to 1.12 +/- 0.53D in group I and 0.60 +/- 0.83D in group II. Manifest refraction were outside +/- 1D of spherical lens or 0.5 D of cylinder lens in 23.6 % in group I and 13.5% in group II. CONCLUSIONS: We suggests that PRK using flying spot laser effectively more reduces corneal astigmatism and provided more satisfactory predictability in refractive results than that of broad beam laser.
Astigmatism ; Diptera* ; Humans ; Lasers, Excimer* ; Photorefractive Keratectomy*

PURPOSE: To investigate the relationship of refraction, geometry of the posterior corneal surface and the residual corneal thickness after excimer laser photorefractive keratectomy. METHODS: Thirty eyes of 15 patients were treated with Star S2 Smooth Scan (VISX, U.S.A.) and followed up for 3 months. The refractive, anteroposterior changes in the posterior corneal surface and residual corneal thickness were measured using slit-scanning topography, Orbscan IIR (Orbtek, Bausch & Lomb) at 1 week preoperatively, and 1 and 3 months postoperatively. RESULTS: Mean forward shift of the posterior cornea surface was 8.83+/-1.34 micrometer, 11.53+/-4.23 micrometer and 14.70+/-3.50 micrometer at 1 week, 1 month, and 3 months respectively. Mean spherical equivalence of posterior cornea was = -7.01+/-0.31 D preoperatively; it changed to -7.17+/-0.47 D, -7.22+/-0.21 D and -7.17+/-0.6 D at 1 week, 1 month and 3 months. The degree of forward shift of posterior corneal surface is correlated with the posterior corneal refractive changes (r=-0.808, P< 0.01). The forward shift of the posterior corneal surface is correlated with the residual corneal thickness (r=-0.483, P< 0.01). CONCLUSIONS: Photorefractive keratectomy significantly influenced the forward shift of the cornea, which is correlated with the residual corneal thickness.
Cornea ; Humans ; Lasers, Excimer ; Photorefractive Keratectomy*

PURPOSE: To investigate the structural changes of anterior chamber after photorefractive keratectomy in myopic eyes, we assessed the changes of anterior chamber(AC) depth, angle and correlations with ablation depth at sixth postoperative month. METHODS: We performed photorefractive keratectomy on 77 eyes of 40 patients and divided them into 3 groups by the degree of preoperative myopia; less than -4.0 diopter, between -4.0 and -6.0 diopter and greater than -6.0 diopter. We assessed the changes of AC depth and angle using Scheimpflug camera(EAS-1000, Nidek, Japan) after 6 months. RESULTS: The average preoperative AC depth and angle were 3.59+/-0.27 mm, 44.20+/-2.58 and 3.53+/-0.27 mm, 43.29+/-1.65 at sixth postoperative month. The reductions in AC depth and AC angle were statistically significant(P<0.05), and there were no differences among three myopia groups(P>0.05). The changes of both AC depth and AC angle were not affected by ablation depth(P>0.05). CONCLUSIONS: Structural changes of anterior chamber were significant 6 months after photorefractive keratectomy and the changes were not affected by degree of myopia nor by ablation depth.
Anterior Chamber* ; Humans ; Myopia ; Photorefractive Keratectomy*

PURPOSE: To investigate the preoperative characteristics and postoperative change of the higher-order wavefront aberrations (HOAs) in myopic photorefractive keratectomy (PRK). METHODS: Standard PRK was performed in 39 eyes (spherical equivalent -4.71+/-1.56D) using the VISX(R) STAR S4(TM) excimer laser system. Wavefront analysis was performed preoperatively and 6 months postoperatively using the VISX(R) WaveScan(TM) aberrometer. Statistical analysis was performed to assess the preoperative characteristics of the HOAs and the PRK-induced aberrations. RESULTS: The preoperative root mean square (RMS) value of the total HOAs was 0.291 micrometer: coma 0.159 micrometer, trefoil 0.157 micrometer, spherical aberration 0.093 micrometer. Among the 3 HOAs, only the spherical aberration showed moderate magnitude negative correlation with the spherical equivalent (p=0.012) and sphere (p=0.005). The magnitude of all of the HOAs, except trefoil, were significantly increased at postoperative 6 months: total HOAs 183% (0.533 micrometer, p<0.001), spherical aberration 341% (0.317 micrometer, p<0.001), coma 185% (0.294 micrometer, p<0.001), trefoil 104% (0.163 micrometer, p=0.681). In the postoperative correlation analysis, only the PRK-induced spherical aberration showed the increase of magnitude with increasing preoperative spherical equivalent (p=0.036) and sphere (p=0.019). CONCLUSIONS: The HOAs, especially spherical aberration and coma, were increased after PRK. Among the 3 HOAs, the spherical aberration showed the greatest increase of magnitude and percent change; it also showed a positive correlation with increasing preoperative spherical equivalent and sphere. Further software improvements in the wavefront-guided surface ablations need to have a diminution of PRK-induced spherical aberration.
Coma ; Lasers, Excimer ; Lotus ; Photorefractive Keratectomy

PURPOSE: To compare higher-order aberrations (HOAs) and visual acuity after wavefront-guided and wavefront-optimized laser keratorefractive surgery. METHODS: This retrospective study consisted of consecutive cases of eyes that underwent wavefront-guided (VISX S4 CustomVue(R)) or wavefront-optimized (WaveLight(R) EX500) laser assisted in situ keratomileusis (LASIK) or photorefractive keratectomy (PRK). Preoperative and postoperative uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), manifest refraction spherical equivalent (MRSE), and preoperative and 3 month postoperative HOAs were compared. RESULTS: There were no statistical differences in UCVA, BCVA, MRSE, or total HOAs in either the LASIK and PRK groups (all p > 0.05). Induced amount of spherical aberration (SA) was significantly lower in the wavefront-optimized LASIK and PRK than wavefront-guided LASIK and PRK. CONCLUSIONS: In laser keratorefractive surgery, wavefront-guided and wavefront-optimized platforms produced equivalent visual outcomes and no differences in total HOAs. However, the wavefront-optimized platform caused less spherical aberration 3 months after operation.
Keratomileusis, Laser In Situ ; Photorefractive Keratectomy ; Retrospective Studies ; Visual Acuity*

PURPOSE: To investigate the effect of surface fluid on the ablation rate and efficacy of 213-nm solid-state laser during photorefractive keratectomy (PRK). METHODS: Twelve rabbits (24 eyes) underwent myopic PRK for the correction of 10 diopters using 213-nm solid-state laser. Photoablation was performed with removal of corneal surface fluid using the Weckcel(R) sponge every 5 seconds in one eye and without removal of corneal surface fluid in the control eye. The mean central corneal thickness (CCT) was evaluated preoperatively, and at 1 week, 4 weeks postoperatively. RESULTS: The mean CCT of group 1 (with removal of corneal surface fluid) were 361.3+/-13.9 micrometer preoperatively and 321.4+/-18.5 micrometer at 4 weeks postoperatively. The mean CCT of group 2 (without removal of surface fluid) were 358.7+/-8.9 micrometer preoperatively and 338.4+/-12.0 micrometer at 4 weeks postoperatively. The mean ablation depths were 39.8+/-7.4 micrometer in group 1 and 20.3+/-5.8 micrometer in group 2 at 4 weeks postoperatively p<0.05). CONCLUSIONS: Induced corneal surface fluid during PRK may influence the ablation efficacy and accuracy of solid-state laser. This result should be considered in clinical trialswith 213-nm solid-state laser, especially in high myopes.
Eye ; Lasers, Solid-State ; Photorefractive Keratectomy ; Porifera ; Rabbits

PURPOSE: To compare the clinical results of photorefractive keratectomy using blade and those of using brush for epithelial removal. METHODS: We have followed up the forty four eyes which were deepithelized using blade(group 1) and the forty four eyes done using brush(group 2). RESULTS: The mean follow-up months was 8.09+/-0.02 in group 1 and 8.36+/-0.91 in group 2. The percentage of eyes which uncorrected visual acuity(UCVA) is better than 20/40 was 77%, 93%, 98% in group 1 and 86%, 97%, 100% in group 2, and better than 20/25 was 31%, 75%, 93% in group 1 and 38%, 77%, 100% in group 2 at 1 week, 2 and 6 months, respectively. And there is no statistical difference between group 1 and 2(p>0.05) about the percentage of eyes with UCVA better than 20/24 and 20/25. Postoperative mean spherical equivalent(D)(Mean +/-2SD) of group 1 was 0.63+/-0.11 and that of group 2 was -0.0038+/-0.93 at 1 week. This means that group 1 was significantly(p=0.004) more overcorrected than group 2 at 1 week. The predictability of operation(the percentage of eyes of which spherical equivalent was lesser than +/-0.5D) was 43%, 50%, 57% in group 1 and 55%, 64%, 67% in group 2 at 1 week, 2, and 6 months, respectively. Group 2 showed higher predictability of operation than group 1, but there was no statistical difference. Postoperative corneal thickness and IOP changes between the two groups was not statistically different(p>0.05). CONCLUSIONS: These results show that epithelial removal during PRK using brush was less overcorrected at early postoperative period, and could get as good refractive result and uncorrected visual acuity as that using blade.
Follow-Up Studies ; Photorefractive Keratectomy ; Postoperative Period ; Visual Acuity

We studied the relationship between the prevalence of lattice degeneration and the axial length in patients with myopia who had undergone photorefractive keratectomy(PRK). 355 eyes of 186 myopic patients with axial length of 22.99mm~30.67mm were evaluated by using A-scan axial length measurements and fundus examination. The myopic patients with posterior staphyloma did not undergo PRK.Eyes were classified into three groups on the basis of axial length:mild(<26mm), moderate(26~28 mm)and severe(>28mm)axial myopia.The prevalence of lattice degeneration was then studied according to axial length group. The highest prevalence of lattice degeneration(13 of 35 eyes, 37.1%)was found among eyes of axial length 28 mmor greater;the lowest prevalence of lattice degeneration(10 of 174 eyes, 5.7%)was found among eyes of axial length under 26 mm. We could find statistically significant association between the prevalence of lattice degeneration and axial length(X2 27.356 P-value<0.005). Unless the axial myopia is related to posterior staphyloma, this may explain the observation that lattice degeneration has been noted more commonly among patients with severe than mild or moderate axial myopia. As lattice degeneration is recognized as a frequent cause of retinal detachment, we recommend peripheral fundus examination be done carefully before PRK or LASIK.
Humans ; Keratomileusis, Laser In Situ ; Myopia ; Photorefractive Keratectomy ; Prevalence ; Retinal Detachment