Ghoreishi Mohammad, Abtahi Mohammad-Ali, Seyedzadeh Iman, Fesharaki Hamid, Mohammadnia Mohadeseh, Jahanbani-Ardakani Hamidreza, Abtahi Seyed-Hossein
Research and Development Department, Persian Eye Clinic, Isfahan, Iran.
Isfahan Eye Research Center, Feiz Eye Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
J Res Med Sci. 2017 Jul 28;22:82. doi: 10.4103/jrms.JRMS_478_15. eCollection 2017.
The aim of this study is to evaluate the results of photorefractive keratectomy (PRK) in the management of postoperative hyperopia and astigmatism in patients with history of radial keratotomy (RK).
This prospective nonrandomized noncomparative interventional case series enrolled consecutive eyes treated with PRK after RK. In cases, in which (1) wavefront (WF) scan was undetectable during primary examinations; and/or, (2) WF data were not transferable to the excimer laser device, patients were treated with the tissue-saving (TS) mode. Patients with detectable/transferable WF were assigned to WF-guided advanced personalized treatment (APT).
Thirty-two and 47 eyes were managed by APT and TS modes, respectively. Pooled analysis of both APT and TS groups showed improvement in uncorrected distant visual acuity and corrected distant visual acuity. The amount of sphere, cylinder, corneal cylinder, spherical equivalent, defocus equivalent, and total aberration showed improvement as well.
PRK seems to bring favorable outcome and safety profile in the management of post-RK hyperopia and astigmatism. It is crucial for practitioners to warn their patients about the fact that they may still have progressive refractive instability regardless of their choice on the laser method of vision correction.
本研究旨在评估准分子激光角膜切削术（PRK）治疗有放射状角膜切开术（RK）病史患者术后远视和散光的效果。
本前瞻性非随机非对照干预性病例系列纳入了RK术后接受PRK治疗的连续病例。对于（1）初次检查时无法检测到波前（WF）扫描；和/或（2）WF数据无法传输至准分子激光设备的病例，患者采用组织保存（TS）模式进行治疗。可检测到/可传输WF的患者被分配至WF引导的高级个性化治疗（APT）。
分别有32只眼和47只眼采用APT和TS模式进行治疗。对APT组和TS组的汇总分析显示，未矫正远视力和矫正远视力均有所改善。球镜度、柱镜度、角膜柱镜度、等效球镜度、离焦等效度和总像差也均有所改善。
PRK在治疗RK术后远视和散光方面似乎具有良好的效果和安全性。对于从业者而言，至关重要的是要告知患者，无论他们选择何种激光视力矫正方法，仍可能存在渐进性屈光不稳定的情况。
