Ramin Shahrokh, Moallemi Rad Lina, Abbasi Ali, Rafatifard Alireza, Rahimi Yosra, Ghorbani Somayeh, Sabbaghi Hamideh, Hosseinzadeh Colagar Abasalt
Faculty of Rehabilitation Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Incubation Center for Pharmaceutical Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Med Hypothesis Discov Innov Ophthalmol. 2023 May 31;12(1):9-17. doi: 10.51329/mehdiophthal1465. eCollection 2023 Spring.
Myopic regression is a major complication of photorefractive keratectomy (PRK). The rates and causes vary considerably among different studies. This study aimed to investigate myopic regression at six months after myopic PRK.
In this retrospective cohort study, we included all eligible patients with myopia ranging from - 0.75 to - 9 D, aged 18 to 50 years, who underwent PRK by a single surgeon with the availability of preoperative and postoperative data at six months after the initial procedure. All participants underwent comprehensive ophthalmic examinations preoperatively and at six months post-PRK. Overcorrection was planned based on the participant's age range to achieve the desired refractive result after PRK. All patients received the same postoperative antibiotic and steroid eye drops in a similar dosage regimen, and the contact lenses were removed after complete corneal epithelial healing. Based on the spherical equivalent of refraction six months after PRK, eyes without and with myopic regression were allocated into groups 1 and 2, respectively.
We included 254 eyes of 132 patients who underwent myopic PRK with a mean (standard deviation) age of 30.12 (7.48) years; 82 (62.12%) were women and 50 (37.88%) were men. The frequency of myopic regression was significantly lower in patients with younger age, lower preoperative cylindrical refraction, and lower ablation depth (all < 0.05). Overcorrection was more successful in eyes with low myopia than in eyes with high myopia ( < 0.05). The highest frequency of myopic regression occurred in eyes with moderate myopia (25.68%), followed by eyes with high myopia (20.0%) and low myopia (6.54%). Among different age groups, patients aged ≤ 30 years had a lower frequency of myopic regression. The frequency of myopic regression in the different age groups was 5.0% at 18 - 20 years, 7.46% at 26 - 30 years, 12.28% at 21 - 25 years, 21.31% at 31 - 35 years, and 26.53% at 36 - 50 years.
Overcorrection was more successful in eyes with low myopia than in eyes with high myopia. The success rate was higher in younger patients with lower astigmatism and ablation depths. Myopic regression was most frequent in eyes with moderate myopia, followed by those with high and low myopia. Further studies should replicate our findings over a longer follow-up period with a larger sample size before generalization is warranted.
近视回退是准分子激光角膜切削术（PRK）的主要并发症。不同研究中的发生率和原因差异很大。本研究旨在调查近视PRK术后6个月的近视回退情况。
在这项回顾性队列研究中，我们纳入了所有符合条件的近视患者，近视度数在-0.75至-9D之间，年龄在18至50岁，由同一位外科医生进行PRK手术，且在初次手术后6个月有术前和术后数据。所有参与者在术前和PRK术后6个月均接受了全面的眼科检查。根据参与者的年龄范围计划过矫，以在PRK术后获得理想的屈光结果。所有患者均接受相同的术后抗生素和类固醇眼药水，剂量方案相似，在角膜上皮完全愈合后取出隐形眼镜。根据PRK术后6个月的等效球镜度数，将无近视回退和有近视回退的眼睛分别分为第1组和第2组。
我们纳入了132例接受近视PRK手术的患者的254只眼睛，平均（标准差）年龄为30.12（7.48）岁；女性82例（62.12%），男性50例（37.88%）。年龄较小、术前柱镜度数较低和切削深度较低的患者近视回退频率显著较低（均P<0.05）。低度近视眼中过矫比高度近视眼中更成功（P<0.05）。中度近视眼中近视回退频率最高（25.68%），其次是高度近视眼（20.0%）和低度近视眼（6.54%）。在不同年龄组中，年龄≤30岁的患者近视回退频率较低。不同年龄组的近视回退频率分别为：18 - 20岁为5.0%，26 - 30岁为7.46%，21 - 25岁为12.28%，31 - 35岁为21.31%，36 - 50岁为26.53%。
低度近视眼中过矫比高度近视眼中更成功。散光和切削深度较低的年轻患者成功率更高。中度近视眼中近视回退最常见，其次是高度近视和低度近视眼。在进行推广之前，进一步的研究应在更大样本量和更长随访期内重复我们的研究结果。
