A Retrospective Review of Photorefractive Keratectomy to Enhance Earlier Radial Keratotomy

Sher, Neal A.; Golben, Mikhail P.; Bond, William I; Trattler, William

doi:10.1097/iio.0b013e31820f88f0

Cited by 4 publications

(8 citation statements)

References 12 publications

(17 reference statements)

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“…[ 18 19 ] About the advantages of PRK over LASIK, the following points are noteworthy: first: PRK avoids additive weakening of the cornea, as a risk factor of ectasia; and second: PRK does not interrupt with RK incisions, saving the remaining corneal structural integrity. [ 20 ] Corneal ectasia has occurred neither in the present study nor in our daily practice over recent years. Taken together, based on the current literature on the management of post-RK hyperopia, PRK seems to be a reasonable method with a favorable safety profile.…”

Section: Discussionmentioning

confidence: 52%

“…To manage such a complicated condition, LASIK and PRK have been proposed to be promising. [ 18 19 20 ] Although either mechanical microkeratome or the femtosecond LASIK surgeries have shown favorable initial outcomes, such methods are not without complications. [ 18 19 ] Flap-related issues, especially epithelial in growth and splitting RK incisions can cause flap fragmentation along with the possibility corneal ectasia.…”

Section: Discussionmentioning

confidence: 99%

“…[ 19 ] With administration of MMC in PRK, corneal haze has become less important. [ 20 ] In some reports, there had been a matter of uncertainty about the safety of using MMC in RK because increased permeability of the cornea for MMC due to deep RK incisions could cause excessive toxicity to the eye. [ 18 ] Notwithstanding, use of MMC for 60 s in a study and up to 40 s in another caused no endothelial cell loss after 1 year.…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, patients and practitioners should be aware that refractive correction is not in deal with the cornea structural stabilization. [ 20 ] In spite of an early reduction in hyperopia with corrective methods, hyperopic changes are shown to persist in most of the cases; and in this regard, factors that might play role are RK-induced progressive central corneal flattening, alterations in the lens, and post-PRK corneal healing. [ 21 ]…”

Section: Discussionmentioning

confidence: 99%

“…[ 17 ] One of the protocols employs off-label use of intraoperative mitomycin-C (MMC) which can effectively control cornea haze as a major complication of post-RK PRK. [ 18 19 20 ] As far as, we have been able to ascertain, the only recent large report on this topic comes from Brazil that enrolled 61 eyes,[ 21 ] since then few large series of patients has yet to be studied. [ 22 23 ] The present study was planned to address this topic and evaluate the refractive efficacy and safety of PRK with MMC in the management of post-RK hyperopia and astigmatism in a large Iranian cohort.…”

Section: Introductionmentioning

confidence: 99%

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Photorefractive keratectomy in the management of postradial keratotomy hyperopia and astigmatism

et al. 2017

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Background:The aim of this study is to evaluate the results of photorefractive keratectomy (PRK) in the management of postoperative hyperopia and astigmatism in patients with history of radial keratotomy (RK).Materials and Methods:This prospective nonrandomized noncomparative interventional case series enrolled consecutive eyes treated with PRK after RK. In cases, in which (1) wavefront (WF) scan was undetectable during primary examinations; and/or, (2) WF data were not transferable to the excimer laser device, patients were treated with the tissue-saving (TS) mode. Patients with detectable/transferable WF were assigned to WF-guided advanced personalized treatment (APT).Results:Thirty-two and 47 eyes were managed by APT and TS modes, respectively. Pooled analysis of both APT and TS groups showed improvement in uncorrected distant visual acuity and corrected distant visual acuity. The amount of sphere, cylinder, corneal cylinder, spherical equivalent, defocus equivalent, and total aberration showed improvement as well.Conclusion:PRK seems to bring favorable outcome and safety profile in the management of post-RK hyperopia and astigmatism. It is crucial for practitioners to warn their patients about the fact that they may still have progressive refractive instability regardless of their choice on the laser method of vision correction.

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Section: Discussionmentioning

confidence: 52%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Photorefractive keratectomy in the management of postradial keratotomy hyperopia and astigmatism

et al. 2017

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Laser Vision Correction after Radial Keratotomy: A Systematic Review and Meta-analysis

Koosha,

Riazi,

Janfaza

et al. 2024

J Cataract Refract Surg

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Laser vision correction for residual refractive errors in patients with previous radial keratotomy (RK) presents a challenging task. Different techniques have been used with varying outcomes. This study aimed to systematically review published manuscripts on refractive surgeries in post-RK patients search in PubMed, Scopus, and Web of Science. The final analysis included 35 studies that described a total of 888 eyes. Our systematic review and meta-analysis demonstrated a significant improvement in uncorrected distance visual acuity (UDVA) for photorefractive keratectomy, topography-guided-PRK, wavefront-guided-PRK, and femtosecond- laser-assisted in situ keratomileusis (LASIK), while mechanical microkeratome LASIK did not yield such significant improvements. Moreover, our results suggest that hyperopic post-RK patients had a significant improvement in UDVA, whereas no such improvement was observed in myopic patients.

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Double safe suture during cataract surgery on post radial keratotomy patients using clear corneal incisions

Meduri

Oliverio

Severo

et al. 2022

European Journal of Ophthalmology

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Purpose the aim of this study is to find a safer surgical approach in cataract surgery on eyes previously treated with radial keratotomy using clear corneal incisions. Setting Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Ophthalmology Clinic, University of Messina, Messina, Italy. Design Prospective study. Methods A prospective study was conducted on a group of 20 patients, 21 eyes with 16 RK incisions were evaluated for cataract phacoemulsification. Samples were divided into two groups: Group 1 underwent surgery with pre-operative one corneal stitch along radial keratotomy incisions near the main access site whereas Group 2 underwent modified surgery with two corneal stitches. Results After surgery, visual acuity, corneal hysteresis and corneal strength was evaluated. In all cases, an increased visual acuity was observed. Group 1 showed an UCVA of logMAR 0.22 ± 0.14, while group 2 presented a logMAR of 0.1 ± 0.07. Data did not show a statistically significant difference in UCVA after surgery between the two groups ( P = 0.133). Instead, a significant difference in corneal hysteresis (CH), respectively with values of 8.65 ± 1.6 mmHg in group 1 and 9.2 ± 1.8 in group 2 ( P = 0.031), and a corneal resistance factor (CRF) with values of 7.87 ± 1.4 mmHg in the first group and 8.65 ± 1.6 mmHg in the second one ( P = 0.039) was observed. Conclusions Double safe suture technique offers better stabilization of corneal structure during surgery in patients preventively treated with 16 incisions RK.

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A Retrospective Review of Photorefractive Keratectomy to Enhance Earlier Radial Keratotomy

Cited by 4 publications

References 12 publications

Photorefractive keratectomy in the management of postradial keratotomy hyperopia and astigmatism

Photorefractive keratectomy in the management of postradial keratotomy hyperopia and astigmatism

Laser Vision Correction after Radial Keratotomy: A Systematic Review and Meta-analysis

Double safe suture during cataract surgery on post radial keratotomy patients using clear corneal incisions

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