The Safety and Efficacy of Photorefractive Keratectomy After Laser in situ Keratomileusis

Journal of Refractive Surgery Vol. 21 No. 4 July/August 2005

Naazli M. Shaikh, MD; Curt E. Wee, OD; Stephen C. Kaufman, MD, PhD

PURPOSE
To determine the safety and efficacy of performing photorefractive keratectomy (PRK) in corneas previously treated with laser in situ keratomileusis (LASIK) surgery.

METHODS
Fifteen eyes of 14 patients who had initially received LASIK for the treatment of myopia and compound myopic astigmatism were evaluated. Variables included existence of and/or type of flap complication associated with the original LASIK procedure, refractions before and after (3 and 6 months) PRK, uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), and the development of complications after PRK such as haze, scarring, double vision, or ghosting.

RESULTS
All 15 eyes were available for analysis at 6 months. Eleven eyes had experienced flap complications during the initial LASIK procedure and 4 eyes had experienced complications in the LASIK postoperative period. Characteristics prior to performing PRK included 11 myopic and 4 hyperopic eyes. By 6 months after PRK treatment, 87% of eyes had UCVA > 20/40, 53% had > 20/25, and 40% had > 20/20. All eyes had BSCVA of > 20/30, with 73% being > 20/20. No eye had lost 2 lines of BSCVA and only 1 eye lost 1 line of BSCVA. Sixty percent of eyes were within 1.0 diopters (D) of emmetropia, and 40% were within 0.5 D of emmetropia. A trend towards undercorrection and surgical induction of astigmatism as confirmed by vector analysis was noted. No eye developed significant haze or scarring.

CONCLUSIONS
Photorefractive keratectomy may be a safe procedure to perform in corneas previously treated with LASIK surgery. Results show good reduction of refractive error and improvement of UCVA and BSCVA. A significant undercorrection of astigmatism was attributed to surgically induced astigmatism. Further studies are necessary to determine the long-term safety and stability of outcomes. [J Refract Surg. 2005;21:353-358.]

What so many researchers seem not to grasp is that if the only issue was a problem with refractive error, we would simply be able to put on a pair of glasses and see well again. I'd be happy to have my original -10.5 x 2 x 125 refractive error if a pair of *Coca Cola* bottle bottoms would fix it and give me clear vision again!!! PRK won't do a thing for us, and could very possibly leave us in even worse straits that we are presently.

quote:

I'd be happy to have my original -10.5 x 2 x 125 refractive error if a pair of *Coca Cola* bottle bottoms would fix it and give me clear vision again!!! PRK won't do a thing for us, and could very possibly leave us in even worse straits that we are presently.

Amen to that! My script would be 1 diopter less but that about wraps it up!

Also, you would be surprised at how many times I have been recommended for PRK even since the botched cataract operation. My cornea in that eye is mush and i don't think cutting it up will help. Since lasik messed it up, then wrong iol, some think PRK will be the fix. I'm Catherine Zeta-Jones, too.