Functional outcome and satisfaction after photorefractive keratectomy - Part 2: Survey of 690 patients

Purpose: To document patient satisfaction and self-perceived quality of vis ion after bilateral photorefractive keratectomy (PRK). Design: Noncomparative, interventional case series. Participants: Consecutive patients who underwent bilateral PRK from May 199 4 through May 1997 by the 12 surgeons of four collaborating centers with a minimum of 4 months since the last surgery and up to 30 months since the fi rst surgery. Methods: A questionnaire with known psychometric properties was self-admini stered by the patients. Main Outcome Measurer Responses to individual questions and scale scores. Results: A total of 929 questionnaires were sent, of which 690 were answere d and returned (74.3% response rate). The preoperative spherical equivalent ranged from -0.38 diopters [D] to -27.75 D (mean, -5.32 D; standard deviat ion, 2.85 D). Although 91.8% of the patients were satisfied or very satisfi ed with their surgery, 96.3% considered that their main goal had been reach ed, and 95.7% would still choose to have surgery if they had it to do over. The degree of satisfaction was proportional to the postoperative uncorrect ed visual acuity in the best eye expressed in LogMAR (r = -0.18, P = 0.0001 ) and was negatively correlated with the importance of the corneal haze (r = -0.23, P = 0.0001). Daytime glare was reported to be greater than before surgery by 55.1% of patients. A decrease in night vision was reported by 31 .7% of patients, and 31.1% of patients reported increased difficulty drivin g at night because of their vision. Conclusions: Overall satisfaction after PRK for low to severe myopia appear s to be very good. Glare and night vision disturbance, particularly bothers ome for night driving, seem to constitute significant secondary effects tha t deserve further investigation and should be kept in mind for future impro vements in the technique. Ophthalmology 2000;107:1790-1796 (C) 2000 by the American Academy of Ophthalmology.