ESCRS - POREF240 - Clinical Outcomes Of Prk In High Myopia (> −6.00 D): A Retrospective Analysis Of 974 Eyes

Clinical Outcomes Of Prk In High Myopia (> −6.00 D): A Retrospective Analysis Of 974 Eyes

Published 2026 - 44th Congress of the ESCRS

Reference: POREF240 | Type: Free paper | DOI: 10.82333/nzth-8t89

Authors: Prof. Madhu Uddaraju* 1

1Advanced Cataract and Cornea,Dr Ramana Rajus VisionTree,Visakhapatnam ,India

Purpose

To evaluate visual outcomes, stromal safety parameters, and complication profile following photorefractive keratectomy (PRK) in high myopia (> −6.00 D) with or without astigmatism up to −2.00 D.

Setting

Single-center tertiary refractive surgery practice, India.

Methods

This retrospective observational study included 974 eyes of 487 patients undergoing PRK for spherical myopia > −6.00 D with cylinder ≤ −2.00 D. All treatments were planned using pachymetry-guided ablation (13 µm per diopter) ensuring a residual stromal bed (RSB) ≥ 380 µm.

 

Primary outcome was postoperative uncorrected visual acuity (UCVA). Secondary outcomes included postoperative pain scores (0–10 scale), incidence of corneal haze, regression, and enhancement rates.

 

Continuous variables are reported as mean ± SD with 95% confidence intervals (CI). Proportions are reported with Wilson 95% CI.

Results

Baseline Characteristics

  • Age: 29.38 ± 5.19 years (95% CI: 29.06–29.71)

  • Sex distribution: 50.1% female

  • Spherical power: −6.99 ± 0.58 D (95% CI: −7.02 to −6.95)

  • Cylinder: −0.99 ± 0.57 D (95% CI: −1.03 to −0.96)

  • Preoperative pachymetry: 529.77 ± 17.59 µm (95% CI: 528.66–530.87)

  • Estimated ablation depth: 90.83 ± 7.58 µm (95% CI: 90.36–91.31)

  • Residual stromal bed: 399.66 ± 11.58 µm (95% CI: 398.94–400.39)

Visual Outcomes (n = 974)

  • 6/6 UCVA: 935 eyes (95.996%)

    95% CI: 94.57%–97.06%

  • 6/9 UCVA: 24 eyes (2.46%)

    95% CI: 1.66%–3.64%

  • 6/12 UCVA: 15 eyes (1.54%)

    95% CI: 0.94%–2.53%

Complications

  • Corneal haze: 6 eyes (0.62%; 95% CI: 0.28%–1.34%)

  • Regression: 16 eyes (1.64%; 95% CI: 1.01%–2.65%)

No sight-threatening complications were observed.

Conclusions

In carefully selected high myopic eyes (> −6.00 D) with stringent stromal preservation (RSB ≥ 380 µm), PRK demonstrates:

  • Excellent visual outcomes (96% achieving 6/6 UCVA)

  • Low haze incidence (0.62%)

  • Low regression rate (1.64%)

  • Predictable and self-limiting postoperative discomfort

These results support PRK as a safe and effective option for high myopia when strict pachymetric criteria are adhered to.