Photorefractive keratectomy for post-penetrating keratoplasty myopia and astigmatism

Purpose: To determine the safely, effectiveness, and predictability of phot orefractive keratectomy (PRK) for the correction of myopia and astigmatism after penetrating keratoplasty. Setting: Gazi University, Medical School, Department of Ophthalmology, Anka ra, Turkey. Methods: Photorefractive keratectomy was performed in 16 eyes of 16 patient s with postkeratoplasty myopia and astigmatism who were unable to wear glas ses due to anisometropia and were contact lens intolerant. They were examin ed for uncorrected visual acuity (UCVA), best spectacle-corrected visual ac uity (BSCVA), and corneal transplant integrity before and after surgery. Results: The mean follow-up after PRK was 26.0 months +/- 15.7 (SD) (range 12 to 63 months). The mean preoperative spherical equivalent refraction of -4.47 +/- 1.39 diopters (D) was -3.39 +/- 1.84 D (P >.05) at the last posto perative visit and the mean preoperative cylinder of -5.62 +/- 2.88 D was - 3.23 +/- 1.70 D (P <.05); refractive regression correlated with the amount of ablation performed. The BSCVA decreased in 3 eyes (18.8%), and the UCVA decreased in 2 (12.5%). Six eyes (37.5%) had grade 2 to 3 haze, which resol ved spontaneously in 4 eyes within a relatively long time but caused a decr ease in BSCVA in 2 (12.5%). Two of the eyes (12.5%) had a rejection episode after PRK and were successfully treated with topical steroids. Conclusions: Photorefractive keratectomy to correct postkeratoplasty myopia and astigmatism appears to be less effective and less predictable than PRK for naturally occurring myopia and astigmatism. Corneal haze and refractiv e regression are more prevalent, and patient satisfaction is not good. J Ca taract Refract Surg 2000; 26: 1590-1595 (C) 2000 ASCRS and ESCRS.