Prk In Suspected Corneas: 24-Year-Follow-Up

To evaluate the long-term effectiveness and safety of photorefractive keratectomy (PRK) with excimer laser in suspected keratoconus corneas.

Instituto de la Vision, Buenos Aires, Argentina 

Eighty-two eyes of forty-four patients with suspected keratoconus corneas (44% female; 56% male) were analyzed. All underwent PRK with the following excimer lasers: Technolas 217z ( Bausch & Lomb, Munich, Germany) and WaveLight EX500 (Alcon, Ulm, Germany). Mean follow-up was 17.2 ± 4.7 years, with a maximum of 24 years. Mean age at surgery was 35.0 ± 3.1 years. Corneal topographies were obtained using Orbscan II (Bausch & Lomb, Rochester, NY, USA). 

Statistical Analysis: Descriptive statistics were performed. Pre- and postoperative outcomes were compared using paired tests, and longitudinal changes were assessed with repeated-measures analysis. A p value <0.05 was considered significant.

Preoperatively, mean spherical equivalent (SE) was −3.65 ± 1.22 D, cylinder −1.53 ± 0.52 D, and best spectacle-corrected visual acuity (BSCVA) 0.81 ± 0.19. At last follow-up, mean SE was −0.45 ± 0.44 D, cylinder −0.42 ± 0.35 D, and BSCVA 0.84 ± 0.22. Postoperative uncorrected visual acuity averaged 0.77 ± 0.13. Refraction remained stable throughout follow-up. We also analyzed gains and losses in BSCVA and keratometric evolution.

Photorefractive keratectomy with excimer laser in suspected keratoconus corneas appears to be an effective and safe procedure, providing stable visual and refractive outcomes over very long-term follow-up (up to 24 years).