RESUMEN
PURPOSE: To evaluate refractive and visual outcomes of single-step transepithelial photorefractive keratectomy (transPRK) in the treatment of mixed astigmatism with the use of an aberration-neutral profile and large ablation zone. SETTING: Nicolaus Copernicus University and Oftalmika Eye Hospital, Bydgoszcz, Poland. DESIGN: Retrospective, observational case series. METHODS: This study included patients who underwent transPRK to correct mixed astigmatism and completed the 3-year follow-up. Procedures were performed with an Amaris 750S excimer laser using an aberration-neutral profile and optical zone of 7.2 mm or more. RESULTS: A total 48 eyes of 39 patients were included. Preoperatively, mean spherical manifest refraction was +1.37 ± 0.98 diopter (D) (0.25 to 4.00 D), and astigmatism was -4.00 ± 0.76 D (-2.25 to -6.00 D). Three years postsurgery, it was -0.17 ± 0.26 D and -0.41 ± 0.44 D, respectively. Attempted spherical equivalent correction within ±0.50 D was achieved in 45 eyes (94%) and cylindrical correction in 34 (71%). Preoperative corrected distance visual acuity (CDVA) was 20/20 or better in 38 eyes (79%), and postoperative uncorrected was 20/20 or better in 29 eyes (60.0%). No eye had lost 2 or more Snellen lines of CDVA, whereas 3 eyes (6%) gained 2 or more lines. In 4 eyes (8%), haze of low intensity was observed at the periphery, with scores between 0.5 and 1.0, and only 1 eye getting a score of 2 in 0- to 4-degree scale. CONCLUSIONS: Mixed astigmatism correction with large-ablation-zone transPRK provided good results for efficacy, safety, predictability, and visual outcomes in a 3-year follow-up.
Asunto(s)
Astigmatismo , Queratectomía Fotorrefractiva , Astigmatismo/cirugía , Córnea , Estudios de Seguimiento , Humanos , Láseres de Excímeros/uso terapéutico , Refracción Ocular , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
AIM: To evaluate refractive and visual outcomes of photorefractive keratectomy (PRK) to treat high hyperopia using an aberration-neutral profile and large ablation zone. METHODS: This was a retrospective, consecutive observational case series at the Oftalmika Eye Hospital, Bydgoszcz, Poland. We included 51 consecutive eyes of 34 patients who underwent alcohol-assisted PRK to correct hyperopia within the range of +3.6 to +6.15 D (mean+4.61±0.67 D). Procedures were performed with an Amaris 750S excimer laser (Schwind eye-tech-solutions GmbH, Kleinostheim, Germany) using an aberration-neutral profile and a 10 mm total ablation zone. Refractive results, predictability, safety and efficacy were evaluated 3 years postoperatively. RESULTS: At 1-year postsurgery, the mean manifest refraction spherical equivalent (MRSE) was -0.002±0.43 D and mean cylinder was -0.181±0.31 D, while the values were +0.09±0.46 D and -0.15±0.26 D, respectively, at 2 years (MRSE p<0.001) and +0.15±0.44 D and -0.15±0.26 D, respectively, at 3 years (MRSE p<0.001). 78% of eyes were within ±0.50 D of the attempted spherical equivalent correction. Three years postoperatively, 22% of eyes lost one line of corrected distance visual acuity and 27% gained a line or two. The change in the mean corneal spherical aberrations for the 6 mm zone was from 0.27±0.07 to 0.08±0.13 µm. CONCLUSIONS: High hyperopia correction with PRK using an aberration-neutral profile and large ablation zone provides good efficacy, safety, predictability and visual outcomes. Relatively low change of corneal spherical aberrations and low increase of hyperopia in the first three postoperative years were observed.