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First Author: P.Peña-Garcia SPAIN
Co Author(s): J. Alio F. Abdulla G. Tamayo
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To evaluate safety, efficacy and stability of Photorefractive Keratectomy (PRK) in Keratoconus patients.
Vissum Corporación. Alicante (Spain), Bogota Laser Refractive Institute
This multicentric and retrospective study comprised 21 eyes of (16 patients) diagnosed of keratoconus that underwent PRK. The main outcomes measures (pre and postoperatively) were: keratometry, manifest refraction, uncorrected and corrected visual acuity (UDVA, CDVA), corneal total and high order aberrations (HOA). To assess the significance of differences between preoperative and postoperative data the Wilcoxon Rank Sum test was applied. 14 eyes had a follow up higher or equal to 10months, 10 eyes? 24 months, 7 eyes?36m and 3 eyes? 8 years (up to 102 months). Mean follow up was 29.82ḟ23.55 months (3 to 102). All patients were adequately informed and signed a consent form. The study adhered to the tenets of the Declaration of Helsinki and it was approved by the local ethical committees of the institution involved.
Corneal cylinder decreased significantly from 3.03ḟ1.73D (0.31 to 6.75) to 1.91ḟ1.05D (0.25 to 4.30) (p=0.002). Sphere decreased from -1.93ḟ2.36D (-7.00 to 1.25) to 0.06ḟ0.89D (-1.25 to 3.00) (p=0.001) and cylinder from -2.23ḟ1.33D (-5.00 to -0.50) to -0.90ḟ0.80D (-3.00 to 0.00) (p<0.001). A significant improvement in UDVA was detected. It changed from 0.79ḟ0.47 (0.15 to 1.47) (logMAR) to 0.07ḟ0.12 (0.00 to 0.47). A slight but not significant increase (p=0.074) in CDVA was detected from 0.08ḟ0.11 (0.00 to 0.40) to 0.03ḟ0.06 (0.00 to 0.21). Safety and efficacy index were 1.03ḟ0.08 and 0.91ḟ0.18 respectively.
PRK in keratoconus is a suitable refractive technique since it provides good levels of vision without spectacles, however, this procedure doesnt demonstrate to improve CDVA of keratoconus patients. Although the number of cases (21 eyes) is not high, patients were followed during a quite large follow-up, showing stable results during it. PRK can be an adequate option for the treatment of keratoconus depending on a good selection of the patients and taking into account what are their actual expectations.