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Stable vision seen at 12 years after PRK

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Refractive outcomes of PRK for mild to moderate myopia remain stable up to 12 years after surgery, according to a long-term British study.

Madhavan S. Rajan, MRCOpth, FRCS, and colleagues at St. Thomas’ Hospital in London reported on 68 patients 12 years after they participated in the first U.K. excimer laser clinical trial for the treatment of myopia with PRK. The initial surgery was done with the Summit UV 200 laser with a 4-mm ablation zone. Patients were assigned to one of six groups based on preoperative refraction; patients in each group received identical treatment.

The main outcome measures were refractive stability, refractive predictability, best corrected visual acuity and corneal haze.

Some refractive regression occurred in the first year after the procedure, but there was no significant change in mean spherical equivalent refraction between 1, 6 and 12 years postoperatively, the authors said.

They found that 75% of patients who underwent 2-D corrections and 65% of those who underwent 3-D corrections were within 1 D of intended correction at 12 years.

Four percent had residual corneal haze and 12% had persistent nighttime halos at 12 years. The researchers attributed the halos to the small size of the ablation zone. Dry eye occurred in 3% of patients. No eyes developed corneal ectasia.

“This study highlights the importance of ablation zone size in improving night vision problems and refractive predictability after PRK,” Dr. Rajan said in a press release. “Given that PRK has proven long-term stability, newer developments such as wavefront-guided customized ablations at the corneal surface are likely to yield better results than LASIK, while preserving the biomechanical integrity of the cornea.”

Half the patients in the study were “very happy” with their outcomes, the press release noted. Ten patients (15%) were dissatisfied.

The study is published in the October issue of Ophthalmology. According to a press release from the American Academy of Ophthalmology, this marks the first report on patients followed for more than 10 years after PRK.