Simultaneous aspheric wavefront-guided transepithelial photorefractive keratectomy and phototherapeutic keratectomy to correct aberrations and refractive errors after corneal surgery.

PURPOSE To evaluate the results of combined aspheric wavefront-guided transepithelial excimer laser photorefractive keratectomy (PRK) and phototherapeutic keratectomy (PTK) to correct aberrations and refractive errors after radial keratotomy (RK) or keratoplasty. SETTING Sekal Rovigo Microsurgery Centre, Rovigo, Italy. METHODS This retrospective noncomparative consecutive case series comprised eyes having corneal wavefront-guided transepithelial PRK to correct aberrations followed by PTK (60 to 70 mum depth) without masking fluid. Corneal wavefront topography and a flying-spot excimer laser were used. Complete preoperative and postoperative ophthalmic examinations were performed. RESULTS The mean age of the 26 patients (35 eyes; 17 RK, 18 keratoplasty) at surgery was 47 years +/- 9 (SD) (range 29 to 72 years) and the mean follow-up, 7 +/- 2 months (range 6 to 15 months). Preoperatively, all eyes had irregular astigmatism ranging from 0.50 to 6.50 diopters (D). At the last postoperative follow-up, the uncorrected distance visual acuity was better than 20/40 in 21 eyes (60%) and better than 20/20 in 6 eyes (17%); 25 eyes (71%) were within +/-1.00 D of the attempted spherical equivalent manifest refraction (mean -0.58 +/- 1.06 D; range -3.50 to +1.50 D). No eye lost Snellen lines of corrected distance visual acuity; 8 eyes (23%) had an increase of more than 4 lines. Trace haze developed in 1 eye. CONCLUSION Simultaneous corneal wavefront-guided transepithelial PRK and PTK using an excimer laser was safe and effective in correcting aberrations and refractive errors after RK or keratoplasty. FINANCIAL DISCLOSURE Neither author has a financial or proprietary interest in any material or method mentioned. Additional disclosure is found in the footnotes.