TIME-DELAYED, 2-STEP EXCIMER-LASER PHOTOREFRACTIVE KERATECTOMY TO CORRECT HIGH MYOPIA

BACKGROUND: Besides scarring, undercorrection is an important complica tion of photorefractive keratectomy in myopes over 10.00 diopters. MET HODS: We performed a two-step time delayed photorefractive keratectomy with time-different ablation zone diameters in a 24-year-old female w ith amblyopia to correct a total myopic refraction error of - 10.75 D, In the first session, a simple myopic correction of - 6.50 D with a 5 -millimeter ablation zone was performed, and 6 months later, a second myopic correction of - 4.00 D with a 6.5-millimeter ablation zone was performed. RESULTS: Four months after the second photorefractive kerat ectomy with an ablation zone of 6.5 mm, the refraction was + 0.75 - 2. 25 x 40-degrees and stayed constant for 2 more months. After the secon d treatment, an initial increase in corneal haze was seen, but after 4 months, the corneal haze did not exceed the status before the second treatment. CONCLUSION: A planned two-step, time-delayed photorefractiv e keratectomy with a larger second ablation zone is a possible approac h to overcoming the problem of undercorrection and regression in high myopia.