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Case Reports
. 2015 Aug 5;6(2):260-8.
doi: 10.1159/000431306. eCollection 2015 May-Aug.

Photorefractive Keratectomy in Keratoconus

Deepali Sandeep Tambe  1 , Anders Ivarsen  1 , Jesper Hjortdal  1
Affiliations
Case Reports

Photorefractive Keratectomy in Keratoconus

Deepali Sandeep Tambe et al. Case Rep Ophthalmol. .

Abstract

Purpose: To assess the efficacy and safety of topography-guided photorefractive keratectomy (PRK) for keratoconus and to estimate the subsequent risk of progression.

Methods: This is a retrospective follow-up study. Between 1998 and 2013, 28 eyes of 23 patients (age 17-60) with grade 1-3 keratoconus received topography-guided PRK. Corrected-distance visual acuity (CDVA), keratometry, pachymetry, and corneal topography were assessed before, after 3 months, and at a late follow-up of a median of 7 years after the procedure. Postoperative complications including subsequent keratoplasty were noted.

Results: Of the 28 eyes, 5 (18%percnt;) had undergone corneal transplantation at a median of 7 years (range 3-10) after PRK. Four eyes were not available for follow-up. In the remaining 19 eyes, CDVA was improved in 16 eyes (84.3%percnt;), reduced in 2 eyes (10.5%percnt;), and unchanged in 1 eye (5.2%percnt;). Thus, average CDVA had improved from 0.49 logMAR before PRK to 0.27 logMAR at 3 months, and to 0.24 at the long-term follow-up. The mean spherical equivalent was reduced from - 6.2 to -3.7 dpt after 3 months and to -2.1 dpt at the late follow-up. Similarly, the mean cylinder was reduced from -4.2 to -3.0 dpt after 3 months and at the late follow-up.

Conclusion: Topography-guided PRK in keratoconus may be effective for reducing myopia and astigmatism and may offer a temporary or permanent alternative to keratoplasty in contact lens-intolerant keratoconus. In the present study, we found a low risk of keratoconus progression after PRK.

Keywords: Keratoconus; Photorefractive keratectomy; Refractive surgical procedures.

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Figures

Fig. 1
Fig. 1
Flow diagram showing the total number of keratoconus patients treated with PRK and the number of patients available for the 3-month and long-term follow-up.
Fig. 2
Fig. 2
a CDVA (logMAR) before as well as 3 months and several years (long-term) after topography-guided PRK for keratoconus. b Preoperative and postoperative SE refraction (D). c Preoperative and postoperative cylinder (D). Open circles = 3-month follow-up; closed circles = long-term follow-up.
Fig. 3
Fig. 3
a CCT (μm) before as well as 3 months and several years (long-term) after topography-guided PRK for keratoconus. b Preoperative and postoperative Kmax (D) over the follow-up period. Closed circles = 3-month follow-up; open circles = long-term follow-up.
See this image and copyright information in PMC

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