Topography-guided transepithelial photorefractive keratectomy to correct irregular refractive errors after radial keratotomy

Abstract

Purpose: To evaluate the efficacy and safety of topography-guided transepithelial photorefractive keratectomy (PRK) in a group of patients with post-radial keratotomy (RK) showing irregular corneas. Setting: Feiz University Hospital, Isfahan, Iran. Design: Prospective case series. Methods: Consecutive patients who had irregular astigmatism after RK with stable refraction and topography for at least 1 year were recruited. All eyes had excimer laser topography-guided single-step transepithelial PRK. The efficacy, safety, predictability, and corneal wavefront aberration changes were assessed 6 months after the surgery. Vector analysis was performed using the Alpins method to evaluate the astigmatic treatment. Results: Twenty-two patients (22 eyes) were enrolled. The patients' ages ranged from 37 to 61 years (45.77 years +/- 4.9 SD); there were 12 men (54.54%) and 10 women (45.46%). Uncorrected distance visual acuity significantly improved after 6 months of treatment (0.45 +/- 0.19 logarithm of the minimum angle of resolution logMAR preoperatively and 0.25 +/- 0.19 logMAR after 6 months) (P < .001). Moreover, the corrected distance visual acuity significantly improved at the end of the study (0.14 +/- 0.13 logMAR preoperatively and 0.09 +/- 0.11 logMAR after 6 months) (P = .01). Furthermore, the aberrometric values were significantly reduced at the 6-month visit (P < .001). The mean of the surgically induced astigmatism was 2.15 +/- 1.44 diopters. No significant complication was observed. Conclusion: Topography-guided single-step transepithelial PRK is a safe and effective method for treating the irregular refractive errors in post-RK patients.