One-year Results of Photorefractive Keratectomy With and Without Surface Smoothing Using the Technolas 217C Laser

Abstract

PURPOSE:

To assess the efficacy, predictability, stability, and safety of a smoothing technique in patients with myopia immediately after photorefractive keratectomy (PRK) using a scanning-spot excimer laser.

METHODS:

Using the Technolas 217C excimer laser, PRK was performed on 100 eyes of 54 patients. Ablation zone diameter was 6.0 mm and transition zone diameter was 9.0 mm. The eyes were randomized into two groups: in 50 eyes PRK alone was performed and in the other 50 eyes, a smoothing technique was performed after the initial ablation. Preoperative mean spherical equivalent refraction was -4.98 +/- 1.71 D in the PRK only group (range -2.25 to -8.60 D) and -4.82 +/- 1.61 D in the smoothing group (range -2.00 to -8.00 D). Follow-up was 12 months for all patients.

RESULTS:

At 1 year after surgery, mean manifest spherical equivalent refraction was -0.61 +/- 0.50 D (range -2.25 to +0.62 D) in the PRK only group and in the smoothing group, +0.02 +/- 0.32 D (range -0.75 to +0.75 D). Postoperative regularity topographic indices were lower in the smoothing group than in the PRK group (P<.001).

CONCLUSIONS:

Smoothing after PRK for correction of myopia up to -6.50 D increased surface regularity, as expressed by lower topography surface regularity indices, and reduced the incidence and severity of postoperative haze. We observed higher predictability throughout follow-up in the smoothing group, which may be addressed by a nomogram adjustment in the PRK only group.