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August 1995, Vol 113, No. 8 >
ARTICLE | August 1995

One-Year Evaluation of Excimer Laser Photorefractive Keratectomy for Myopia and Myopic Astigmatism FREE

Grant R. Snibson, FRACO; Catherine A. Carson, PhD, MPH; Geoffrey F. Aldred, BBus; Hugh R. Taylor, MD, FRACO
Arch Ophthalmol. 1995;113(8):994-1000. doi:10.1001/archopht.1995.01100080044028
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Objective:  To evaluate prospectively the efficacy and safety of excimer laser photorefractive keratectomy in the treatment of myopia and myopic astigmatism.

Methods:  Up to 15 diopters (D) of myopia with or without astigmatism of less than 6 D was treated with an excimer laser (VISX Twenty/Twenty). One hundred fifty procedures have been followed up for more than 12 months.

Results:  Postoperative refractions were generally stable after 3 months without significant early overcorrection. Of those eyes treated with spherical equivalents of 5 D or less, 96% were within 1 D of the targeted refraction after photorefractive keratectomy and 88% had uncorrected visual acuities of 20/40 or better. At 12 months, 77% of all 150 eyes treated achieved an uncorrected visual acuity of 20/40 or better and 81% were within 1 D of the intended correction. Nine eyes (6%) lost 2 or more lines of best corrected visual acuity and 14 (9%) gained 2 or more lines. Adverse reactions were reported in 12 patients (8%) during the postoperative period.

Conclusions:  Photorefractive keratectomy is capable of correcting low and moderate myopic errors with a relatively high degree of accuracy and safety. The predictability and stability of the postoperative refraction during the first 12 months seem to be good.

REFERENCES

1 +
Wu WCS, Stark WJ, Green WR.  Corneal wound healing after 193-nm excimer laser keratectomy . Arch Ophthalmol . 1991;;109:1426-1432.
2 +
Trokel SL, Srinivasan R, Braren B.  Excimer laser surgery of the cornea . Am J Ophthalmol . 1983;;96:710-715.
3 +
Sher NA, Bowers RA, Zabel RW, et al.  Clinical use of the 193-nm excimer laser in the treatment of corneal scars . Arch Ophthalmol . 1991;;109:491-498.
4 +
Gartry D, Kerr Muir M, Marshall J.  Excimer laser treatment of corneal surface pathology: a laboratory and clinical study . Br J Ophthalmol . 1991;;75:258-269.
5 +
Tengroth B, Epstein D, Fagerholm P, Hamberg-Nyström H, Fitzsimmons TD.  Excimer laser photorefractive keratectomy for myopia: clinical results in sighted eyes . Ophthalmology . 1993;;100:739-745.
6 +
Heitzmann J, Binder PS, Kassar BS, Nordan LT.  The correction of high myopia using the excimer laser . Arch Ophthalmol . 1993;;111:1627-1634.
7 +
Gartry DS, Kerr Muir MG, Marshall J.  Excimer laser photorefractive keratectomy: 18-month follow-up . Ophthalmology . 1992;;99:1209-1219.
8 +
Sher NA, Barak M, Daya S, et al.  Excimer laser photorefractive keratectomy in high myopia: a multicenter study . Arch Ophthalmol . 1992;;110:935-943.
9 +
Carson CA, Garrett SKM, Taylor HR.  Excimer laser photorefractive keratectomy for extreme myopia . Invest Ophthalmol Vis Sci . 1994;;35( (suppl) ):1487.
10 +
McDonnell PJ, Moreira H, Garbus J, Clapham TN, D'Arcy J, Munnerlyn CR.  Photorefractive keratectomy for astigmatism . Arch Ophthalmol . 1991;;109:710-713.
11 +
McDonnell PJ, Garbus J, Hertzog L, Campos M.  Photorefractive keratectomy for naturally-occurring and post-keratoplasty astigmatism . Invest Ophthalmol Vis Sci . 1992;;33( (suppl) ):761.
12 +
Taylor HR, Kelly P, Alpins N.  Excimer laser correction of myopic astigmatism . J Cataract Refract Surg . 1994;;20( (suppl) ):243-251.
13 +
Taylor HR, Guest CS, Kelly PJ, Alpins NA.  Comparison of excimer laser treatment of astigmatism and myopia . Arch Ophthalmol . 1993;;111:1621-1626.
14 +
Choi YI, Min HK, Hyun PM.  Excimer laser photorefractive keratectomy for astigmatism . Korean J Ophthalmol . 1993;;7:20-24.
15 +
Spigelman AV, Albert WC, Cozean CH, et al.  Treatment of myopic astigmatism with the 193nm excimer laser utilizing aperture elements . J Cataract Refract Surg . 1994;;20( (suppl) ):258-261.
16 +
SAS/STAT Users Guide , Version 6. 4th ed. Cary, NC: SAS Institute Inc; 1990;.
17 +
Alpins NA.  A new method of analysing vectors for changes in astigmatism . J Cataract Refract Surg . 1993;;19:524-533.
18 +
Kim JH, Hahn TW, Lee YC, Joo CK, Sah WJ.  Photorefractive keratectomy in 202 myopic eyes: 1-year results . Refract Corneal Surg . 1993;;9( (suppl) ):S11-S16.
19 +
Salz JJ, Maguen E, Nesburn AB, et al.  A 2-year experience with excimer laser photorefractive keratectomy for myopia . Ophthalmology . 1993;;100:873-882.
20 +
Lawless MA, Rogers C, Cohen P.  Excimer laser photorefractive keratectomy: 12 months' follow-up . Med J Aust . 1993;;159:535-538.
21 +
Snibson GR, Taylor HR.  Retreatment following excimer laser photorefractive keratectomy . Invest Ophthalmol Vis Sci . 1994;;35( (suppl) ):2019.
22 +
Buratto L, Ferrari M.  Photorefractive keratectomy for myopia from 6.00 D to 10.00 D . Refract Corneal Surg . 1993;;9( (suppl) ):S34-S36.
23 +
Brancato R, Carones F, Trabucchi G, Scialdone A, Tavola A.  The erodible mask in photorefractive keratectomy for myopia and astigmatism . Refract Corneal Surg . 1993;;9( (suppl) ):S125-S130.
24 +
Caubet E.  Cause of subepithelial corneal haze over 18 months afterratectomy for myopia . Refract Corneal Surg . 1993;;9( (suppl) ):S65-S70.
25 +
Orssaud C, Ganem S, Binaghi M, et al.  Photorefractive keratectomy in 176 eyes: 1-year follow-up . J Refract Corneal Surg . 1994;;10( (suppl) ):S199-S205.
26 +
Campos M, Cuevas K, Garbus J, Lee M, McDonnell PJ.  Corneal wound healing after excimer laser ablation: effects of nitrogen gas blower . Ophthalmology . 1992;;99:893-897.
27 +
Piebenga LW, Matta CS, Deitz MR, Tauber J, Irvine JW, Sabates FN.  Excimer photorefractive keratectomy for myopia . Ophthalmology . 1993;;100:1335-1345.

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1 +
Wu WCS, Stark WJ, Green WR.  Corneal wound healing after 193-nm excimer laser keratectomy . Arch Ophthalmol . 1991;;109:1426-1432.
2 +
Trokel SL, Srinivasan R, Braren B.  Excimer laser surgery of the cornea . Am J Ophthalmol . 1983;;96:710-715.
3 +
Sher NA, Bowers RA, Zabel RW, et al.  Clinical use of the 193-nm excimer laser in the treatment of corneal scars . Arch Ophthalmol . 1991;;109:491-498.
4 +
Gartry D, Kerr Muir M, Marshall J.  Excimer laser treatment of corneal surface pathology: a laboratory and clinical study . Br J Ophthalmol . 1991;;75:258-269.
5 +
Tengroth B, Epstein D, Fagerholm P, Hamberg-Nyström H, Fitzsimmons TD.  Excimer laser photorefractive keratectomy for myopia: clinical results in sighted eyes . Ophthalmology . 1993;;100:739-745.
6 +
Heitzmann J, Binder PS, Kassar BS, Nordan LT.  The correction of high myopia using the excimer laser . Arch Ophthalmol . 1993;;111:1627-1634.
7 +
Gartry DS, Kerr Muir MG, Marshall J.  Excimer laser photorefractive keratectomy: 18-month follow-up . Ophthalmology . 1992;;99:1209-1219.
8 +
Sher NA, Barak M, Daya S, et al.  Excimer laser photorefractive keratectomy in high myopia: a multicenter study . Arch Ophthalmol . 1992;;110:935-943.
9 +
Carson CA, Garrett SKM, Taylor HR.  Excimer laser photorefractive keratectomy for extreme myopia . Invest Ophthalmol Vis Sci . 1994;;35( (suppl) ):1487.
10 +
McDonnell PJ, Moreira H, Garbus J, Clapham TN, D'Arcy J, Munnerlyn CR.  Photorefractive keratectomy for astigmatism . Arch Ophthalmol . 1991;;109:710-713.
11 +
McDonnell PJ, Garbus J, Hertzog L, Campos M.  Photorefractive keratectomy for naturally-occurring and post-keratoplasty astigmatism . Invest Ophthalmol Vis Sci . 1992;;33( (suppl) ):761.
12 +
Taylor HR, Kelly P, Alpins N.  Excimer laser correction of myopic astigmatism . J Cataract Refract Surg . 1994;;20( (suppl) ):243-251.
13 +
Taylor HR, Guest CS, Kelly PJ, Alpins NA.  Comparison of excimer laser treatment of astigmatism and myopia . Arch Ophthalmol . 1993;;111:1621-1626.
14 +
Choi YI, Min HK, Hyun PM.  Excimer laser photorefractive keratectomy for astigmatism . Korean J Ophthalmol . 1993;;7:20-24.
15 +
Spigelman AV, Albert WC, Cozean CH, et al.  Treatment of myopic astigmatism with the 193nm excimer laser utilizing aperture elements . J Cataract Refract Surg . 1994;;20( (suppl) ):258-261.
16 +
SAS/STAT Users Guide , Version 6. 4th ed. Cary, NC: SAS Institute Inc; 1990;.
17 +
Alpins NA.  A new method of analysing vectors for changes in astigmatism . J Cataract Refract Surg . 1993;;19:524-533.
18 +
Kim JH, Hahn TW, Lee YC, Joo CK, Sah WJ.  Photorefractive keratectomy in 202 myopic eyes: 1-year results . Refract Corneal Surg . 1993;;9( (suppl) ):S11-S16.
19 +
Salz JJ, Maguen E, Nesburn AB, et al.  A 2-year experience with excimer laser photorefractive keratectomy for myopia . Ophthalmology . 1993;;100:873-882.
20 +
Lawless MA, Rogers C, Cohen P.  Excimer laser photorefractive keratectomy: 12 months' follow-up . Med J Aust . 1993;;159:535-538.
21 +
Snibson GR, Taylor HR.  Retreatment following excimer laser photorefractive keratectomy . Invest Ophthalmol Vis Sci . 1994;;35( (suppl) ):2019.
22 +
Buratto L, Ferrari M.  Photorefractive keratectomy for myopia from 6.00 D to 10.00 D . Refract Corneal Surg . 1993;;9( (suppl) ):S34-S36.
23 +
Brancato R, Carones F, Trabucchi G, Scialdone A, Tavola A.  The erodible mask in photorefractive keratectomy for myopia and astigmatism . Refract Corneal Surg . 1993;;9( (suppl) ):S125-S130.
24 +
Caubet E.  Cause of subepithelial corneal haze over 18 months afterratectomy for myopia . Refract Corneal Surg . 1993;;9( (suppl) ):S65-S70.
25 +
Orssaud C, Ganem S, Binaghi M, et al.  Photorefractive keratectomy in 176 eyes: 1-year follow-up . J Refract Corneal Surg . 1994;;10( (suppl) ):S199-S205.
26 +
Campos M, Cuevas K, Garbus J, Lee M, McDonnell PJ.  Corneal wound healing after excimer laser ablation: effects of nitrogen gas blower . Ophthalmology . 1992;;99:893-897.
27 +
Piebenga LW, Matta CS, Deitz MR, Tauber J, Irvine JW, Sabates FN.  Excimer photorefractive keratectomy for myopia . Ophthalmology . 1993;;100:1335-1345.

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