Abstract
Purpose: :
To evaluate safety and efficacy of PRK in patients with pigment dispersion syndrome (PDS).
Methods: :
We reviewed pre- and 1M, 3M, 6M, and 12M post-op records of patients with PDS who underwent PRK between January 2002 and July 2008. Data for analysis included gender, age, ablation depth (AD), surgical complications, manifest spherical equivalent (MSE), uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), intraocular pressure (IOP), central corneal thickness (CCT), cup-to-disc (C/D) ratio, and post-op complications. Pre- and post-op results were compared using a paired T-test and p < 0.05 was considered statistically significant.
Results: :
19 eyes of 10 soldiers (9 males and 1 female) mean age 40.6+/-8.1 years (range 25 to 56 years) with at least 6 months follow-up were included for the review. Mean MSE pre-op was -3.00+/-2.26D (range -1.25 to -7.63D). Mean AD was 47.7+/-26.6 µ (range 17.3 to 113.6 µ). At the final follow-up, mean 342.2 days post-op (range 186 to 1001 days), UCVA was 20/15 or better in 63.2%, 20/20 or better in 84.2%, 20/25 or better in 89.8%, and 20/30 or better in 100% of eyes. Post-op 89.5% of eyes were within 0.5D and 100% within 1.00D of emmetropia. BSCVA was unchanged from pre-op in 78.9% of eyes, while 21.1% of eyes gained one line BSCVA. No eye lost BSCVA from any cause. Post-op IOP (uncorrected) was lower than baseline (17.2+/-3.4 mmHg) at 1M (15.3+/-4.3 mmHg, p=0.006), 3M (15.3+/-4.8 mmHg, p=0.213), 6M (14.7+/-3.9 mmHg, p=0.001), and final (14.3+/-3.7 mmHg, p=0.001). However, when corrected for change in CCT and curvature [IOP = (GAT + 0.025*AD + 0.34*MSE), Rosa et al, 1998] mean post-op IOP was unchanged from baseline at 1M (17.4+/-4.5 mmHg, p=0.77), 3M (17.6+/-4.2 mmHg, p=0.56), 6M (16.9+/-4.1 mmHg, p=0.68), and final (16.5+/-3.4 mmHg, p=0.27). Three of 10 patients (30%) were steroid responders, managed with a single topical agent which was discontinued after completing steroids. There was no significant change in mean C/D ratio from baseline (0.368+/-0.113) to final visit (0.376+/-0.128, p=0.203).
Keywords: refractive surgery: PRK