Visual, refractive, and subjective outcomes after photorefractive keratectomy for myopia of 6 to 10 diopters using the Nidek laser

Purpose: To analyze the results of photorefractive keratectomy (PRK) for my opia of 6.0 to 10.0 diopters (D) using the Nidek laser and compare them wit h those in other series, including LASIK, and to analyze the subjective asp ects of vision. Setting: Remuera Eye Clinic, Auckland, New Zealand, Method: One hundred ninety-two eyes of 162 consecutive PRK patients with a 6 month follow-up were studied. All had myopia in the range of 6.0 to 10.0 D by spherical equivalent. Astigmatism of up to 3.5 D was treated by laser simultaneously. At 6 months, uncorrected visual acuity, best spectacle-corr ected visual acuity, residual refractive error, and corneal haze were recor ded. After the 6 month examination, a questionnaire was sent to all patient s, Results: Uncorrected visual acuity of 20/20 was achieved in 59% of eyes and of 20/40 or better in 94%, The accuracy of correction was +/-0.5 D of emme tropia in 77% and +/-1.0 D in 94%. In 2 eyes (1.0%), corneal haze was asses sed as 2+ and 2 Snellen lines of best corrected visual acuity were lost. Th e questionnaire revealed that 45% of patients had difficulties with night v ision. This was better than before surgery in 35% but worse in 31%. Halos w ere seen around lights by 52%, but these were less than before surgery in 2 1% and worse in 26%. There was undue sensitivity to glare in 29%, but this was better than before surgery in 19% and worse in 28%. The overall quality of vision was better than before surgery in 60% and worse in 17%, Seventy- seven percent did not need spectacles. Ninety-eight percent said they would have the surgery again. Conclusions: As long as the patients are informed of the limitations of PRK for myopia, the results are acceptable. J Cataract Refract Surg 1999; 25:9 36-942 (C) 1999 ASCRS and ESCRS.