Predictability of spherical photorefractive keratectomy for myopia

Objective

This study aimed to examine the effects of purely spherical excimer laser photorefractive keratectomy (PRK) for myopia.

Design

Consecutive case series.

Participants

A total of 3218 eyes with a mean preoperative mean spherical equivalent (MSE) of −3.75 diopters (D) ± 1.73 D standard deviation (SD) (range, −1.00 D to −11.88 D) underwent PRK with a Nidek EC-5000 excimer laser. Eyes were divided into groups based on the degree of preoperative myopia in 1 D steps

Intervention

All eyes underwent PRK with a Nidek EC-5000 excimer laser.

Main outcome measure

Visual and refractive outcome of PRK treatment was measured.

Results

After a mean follow-up period of 52.6 weeks (range, 26–150 weeks), the final MSE was −0.07 D (±0.68 D) (range, −5.50 D to +4.50 D). Of the 3218 eyes, 2919 (90.7%) were within 1.00 D of emmetropia, and 3038 (94.4%) of eyes had an uncorrected visual acuity of 20/40 or better, with 1886 (58.6%) achieving 20/20 or better visual acuity. Eyes in the lower preoperative myopia groups had a greater chance of attaining 20/40 unaided visual acuity than those in the higher groups (e.g., 98.3% of the −2D group and 53.6% of the −9D group achieved 20/40 unaided visual acuity). Overall, mean postoperative haze was 0.29 ± 0.39 SD (scale, 0–3), and 29 eyes (0.9%) lost 0.3 or more logarithm of the minimum angle of resolution (LogMAR) unit of best-corrected visual acuity.

Conclusions

Excimer laser PRK is an effective treatment for myopia of up to −9.00 D. The outcome parameters are less predictable for eyes with greater than −9.00 D of myopia.