Complications of myopic photorefractive keratectomy with the excimer laser.

BACKGROUND

Although many thousands of myopic eyes have been operated on by excimer laser photorefractive keratectomy (PRK), the safety of this procedure is still a concern.

METHODS

The results and complications of PRK have been studied for up to 2 years in a prospective trial including 193 eyes in 146 patients. In addition, specific complications of PRK are described that occurred in patients outside the prospective study.

RESULTS

Two eyes (1.2%) lost two lines of best-spectacle-corrected visual acuity 1 year after surgery, but at 2 years one of these eyes had regained baseline visual acuity. At 1 year, 12 eyes (7.1%) had lost more than two lines of visual acuity under glare conditions. Significant complications such as manifest scarring, overcorrection, undercorrection, and continued regression are dependent on attempted refraction. Eccentric ablations with resultant induced astigmatism are rare and the incidence is dependent on the experience of the surgeon. Progressive hyperopia did not occur.

CONCLUSION

Except in corrections greater than 6 diopters, complications after PRK are rare. Assuming an appropriate patient selection, PRK may be considered a relatively safe procedure compared with other refractive procedures.