Photorefractive Keratectomy With and Without Smoothing: A Bilateral Study

Abstract

PURPOSE:

To assess whether a smoother stromal surface and a faster epithelium regeneration after excimer laser photorefractive keratectomy (PRK) may lead to better visual results.

METHODS:

Ten patients had unilateral PRK and contralateral PRK plus smoothing. The operative outcome was checked by means of digital standardized photographs taken at 0, 20, 40, and 60 hours after surgery. Complete clinical examinations were performed before and 1 and 3 months after surgery.

RESULTS:

Between 20 and 40 hours after surgery, the average velocity of radial epithelial migration in eyes in which smoothing was performed was 0.083 +/- 0.008 mm/h. This was faster than that (0.064 +/- 0.007 mm/h [P<.01]) observed in the eyes without smoothing. The corneal regularity index at 1 and 3 months was worse in the PRK alone group compared to the PRK plus smoothing group (P=.1). At 3 months, better visual outcome and less haze were observed in the PRK plus smoothing group.

CONCLUSION:

When using a flying spot laser, PRK plus smoothing improved the visual results and diminished regression and haze at 3 months, but gave rise to a slight hyperopic shift.