Outcomes of photorefractive keratectomy following laser in situ keratomileusis: a cohort study

Alfonso Iovieno, Joshua C. Teichman, Stephanie Low, Sonia N. Yeung, Marie Eve Lègarè, Alejandro D. Lichtinger, Allan R. Slomovic, David S. Rootman

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Abstract

Objective To analyze the outcomes of photorefractive keratectomy (PRK) on residual myopia and hyperopia post–laser in situ keratomileusis (LASIK) and to compare these results with PRK on eyes without previous laser refractive surgery. Design Retrospective comparative cohort study. Participants Patients undergoing PRK between 2006 and 2010 were reviewed. Methods Patients were divided into 4 groups, myopic or hyperopic PRK post-LASIK (mPRK-PL and hPRK-PL, respectively) and myopic or hyperopic PRK on corneas without previous laser refractive surgery (mPRK and hPRK, respectively). Uncorrected and corrected distance visual acuity, mean refractive spherical equivalent (MRSE), and mean keratometry and aberrations (total, higher order [HOA], coma, trefoil, and spherical aberration) were recorded at months 3 and 6 postoperatively, as were complications and attempted versus achieved MRSE. Results Thirty-three eyes of 25 patients who underwent PRK post-LASIK (21 eyes of 14 patients for hPRK-PL and 12 eyes of 11 patients for mPRK-PL) and 35 eyes of 21 patients who underwent PRK on virgin eyes (11 eyes of 8 patients for hPRK and 24 eyes of 13 patients for mPRK) were included in the study. The only significant differences in outcomes were found to be HOA at 3 months for hPRK-PL as compared with both hPRK and mPRK. Achieved MRSE was significantly different from expected MRSE for hPRK-PL at 3 months postoperatively. No haze- or flap-related complications were observed. Conclusion Outcomes of PRK were not different in myopic and hyperopic corrections post-LASIK by 6 months or when compared with PRK in virgin eyes. HOA may render hPRK-PL results less predictable early in the postoperative period.

Original languageEnglish
Pages (from-to)417-422
Number of pages6
JournalCanadian Journal of Ophthalmology
Volume51
Issue number6
DOIs
Publication statusPublished - Dec 1 2016
Externally publishedYes

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Photorefractive Keratectomy
Laser In Situ Keratomileusis
Cohort Studies
Refractive Surgical Procedures
Laser Therapy
Hyperopia
Myopia
Coma
Postoperative Period
Cornea
Visual Acuity

ASJC Scopus subject areas

  • Medicine(all)
  • Ophthalmology

Cite this

Iovieno, A., Teichman, J. C., Low, S., Yeung, S. N., Eve Lègarè, M., Lichtinger, A. D., ... Rootman, D. S. (2016). Outcomes of photorefractive keratectomy following laser in situ keratomileusis: a cohort study. Canadian Journal of Ophthalmology, 51(6), 417-422. https://doi.org/10.1016/j.jcjo.2016.02.024

Outcomes of photorefractive keratectomy following laser in situ keratomileusis : a cohort study. / Iovieno, Alfonso; Teichman, Joshua C.; Low, Stephanie; Yeung, Sonia N.; Eve Lègarè, Marie; Lichtinger, Alejandro D.; Slomovic, Allan R.; Rootman, David S.

In: Canadian Journal of Ophthalmology, Vol. 51, No. 6, 01.12.2016, p. 417-422.

Research output: Contribution to journalArticle

Iovieno, A, Teichman, JC, Low, S, Yeung, SN, Eve Lègarè, M, Lichtinger, AD, Slomovic, AR & Rootman, DS 2016, 'Outcomes of photorefractive keratectomy following laser in situ keratomileusis: a cohort study', Canadian Journal of Ophthalmology, vol. 51, no. 6, pp. 417-422. https://doi.org/10.1016/j.jcjo.2016.02.024
Iovieno, Alfonso ; Teichman, Joshua C. ; Low, Stephanie ; Yeung, Sonia N. ; Eve Lègarè, Marie ; Lichtinger, Alejandro D. ; Slomovic, Allan R. ; Rootman, David S. / Outcomes of photorefractive keratectomy following laser in situ keratomileusis : a cohort study. In: Canadian Journal of Ophthalmology. 2016 ; Vol. 51, No. 6. pp. 417-422.
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abstract = "Objective To analyze the outcomes of photorefractive keratectomy (PRK) on residual myopia and hyperopia post–laser in situ keratomileusis (LASIK) and to compare these results with PRK on eyes without previous laser refractive surgery. Design Retrospective comparative cohort study. Participants Patients undergoing PRK between 2006 and 2010 were reviewed. Methods Patients were divided into 4 groups, myopic or hyperopic PRK post-LASIK (mPRK-PL and hPRK-PL, respectively) and myopic or hyperopic PRK on corneas without previous laser refractive surgery (mPRK and hPRK, respectively). Uncorrected and corrected distance visual acuity, mean refractive spherical equivalent (MRSE), and mean keratometry and aberrations (total, higher order [HOA], coma, trefoil, and spherical aberration) were recorded at months 3 and 6 postoperatively, as were complications and attempted versus achieved MRSE. Results Thirty-three eyes of 25 patients who underwent PRK post-LASIK (21 eyes of 14 patients for hPRK-PL and 12 eyes of 11 patients for mPRK-PL) and 35 eyes of 21 patients who underwent PRK on virgin eyes (11 eyes of 8 patients for hPRK and 24 eyes of 13 patients for mPRK) were included in the study. The only significant differences in outcomes were found to be HOA at 3 months for hPRK-PL as compared with both hPRK and mPRK. Achieved MRSE was significantly different from expected MRSE for hPRK-PL at 3 months postoperatively. No haze- or flap-related complications were observed. Conclusion Outcomes of PRK were not different in myopic and hyperopic corrections post-LASIK by 6 months or when compared with PRK in virgin eyes. HOA may render hPRK-PL results less predictable early in the postoperative period.",
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AU - Iovieno, Alfonso

AU - Teichman, Joshua C.

AU - Low, Stephanie

AU - Yeung, Sonia N.

AU - Eve Lègarè, Marie

AU - Lichtinger, Alejandro D.

AU - Slomovic, Allan R.

AU - Rootman, David S.

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N2 - Objective To analyze the outcomes of photorefractive keratectomy (PRK) on residual myopia and hyperopia post–laser in situ keratomileusis (LASIK) and to compare these results with PRK on eyes without previous laser refractive surgery. Design Retrospective comparative cohort study. Participants Patients undergoing PRK between 2006 and 2010 were reviewed. Methods Patients were divided into 4 groups, myopic or hyperopic PRK post-LASIK (mPRK-PL and hPRK-PL, respectively) and myopic or hyperopic PRK on corneas without previous laser refractive surgery (mPRK and hPRK, respectively). Uncorrected and corrected distance visual acuity, mean refractive spherical equivalent (MRSE), and mean keratometry and aberrations (total, higher order [HOA], coma, trefoil, and spherical aberration) were recorded at months 3 and 6 postoperatively, as were complications and attempted versus achieved MRSE. Results Thirty-three eyes of 25 patients who underwent PRK post-LASIK (21 eyes of 14 patients for hPRK-PL and 12 eyes of 11 patients for mPRK-PL) and 35 eyes of 21 patients who underwent PRK on virgin eyes (11 eyes of 8 patients for hPRK and 24 eyes of 13 patients for mPRK) were included in the study. The only significant differences in outcomes were found to be HOA at 3 months for hPRK-PL as compared with both hPRK and mPRK. Achieved MRSE was significantly different from expected MRSE for hPRK-PL at 3 months postoperatively. No haze- or flap-related complications were observed. Conclusion Outcomes of PRK were not different in myopic and hyperopic corrections post-LASIK by 6 months or when compared with PRK in virgin eyes. HOA may render hPRK-PL results less predictable early in the postoperative period.

AB - Objective To analyze the outcomes of photorefractive keratectomy (PRK) on residual myopia and hyperopia post–laser in situ keratomileusis (LASIK) and to compare these results with PRK on eyes without previous laser refractive surgery. Design Retrospective comparative cohort study. Participants Patients undergoing PRK between 2006 and 2010 were reviewed. Methods Patients were divided into 4 groups, myopic or hyperopic PRK post-LASIK (mPRK-PL and hPRK-PL, respectively) and myopic or hyperopic PRK on corneas without previous laser refractive surgery (mPRK and hPRK, respectively). Uncorrected and corrected distance visual acuity, mean refractive spherical equivalent (MRSE), and mean keratometry and aberrations (total, higher order [HOA], coma, trefoil, and spherical aberration) were recorded at months 3 and 6 postoperatively, as were complications and attempted versus achieved MRSE. Results Thirty-three eyes of 25 patients who underwent PRK post-LASIK (21 eyes of 14 patients for hPRK-PL and 12 eyes of 11 patients for mPRK-PL) and 35 eyes of 21 patients who underwent PRK on virgin eyes (11 eyes of 8 patients for hPRK and 24 eyes of 13 patients for mPRK) were included in the study. The only significant differences in outcomes were found to be HOA at 3 months for hPRK-PL as compared with both hPRK and mPRK. Achieved MRSE was significantly different from expected MRSE for hPRK-PL at 3 months postoperatively. No haze- or flap-related complications were observed. Conclusion Outcomes of PRK were not different in myopic and hyperopic corrections post-LASIK by 6 months or when compared with PRK in virgin eyes. HOA may render hPRK-PL results less predictable early in the postoperative period.

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