Abstract
Purpose: :
To evaluate the efficacy, predictability and refractive stability of conductive keratoplasty (CK) after photorefractive keratectomy (PRK) for consecutive hyperopia.
Methods: :
A retrospective, noncomparative, interventional case series of patients who underwent CK for consecutive hyperopia that had been stable for at least 3 months after PRK. Uncorrected and best corrected visual acuity, manifest refraction, corneal topography, pachymetry and routine ophthalmic examination data were collected preoperatively, as well as at 1-, 3-, 6- and 12-months postoperatively. All surgeries were performed by a single surgeon (HKW) using the ViewPoint CK system.
Results: :
Nine eyes of 7 patients (4 male, 3 female, mean age 45.5 years old) completed follow-up of at least 6-months. Seven eyes required only one treatment, while 2 eyes required a repeat CK procedure. Mean interval between PRK and CK was 267 days. No intraoperative complications occurred. Mild discomfort was noted in 4 patients, which resolved after postoperative day 1. No patients lost best corrected visual acuity at 6 months. All patients were myopic prior to PRK. Mean manifest refraction spherical equivalent (MRSE) prior to CK enhancement was +1.25 ± 0.32 (0.75 to 1.63) diopters. After CK enhancement, mean MRSE at 1 month was -0.20 ± 0.61 diopters, at 3 months -0.38 ± 0.75 diopters and at 6 months +0.22 ± 0.39 diopters. Mean UCVA at 3 months was 20/25 (range 20/15 to 20/70) and at 6 months was 20/20 (range 20/20 to 20/25). Six of 9 eyes achieved a MRSE within 0.5 diopters of intended goal, one eye was overcorrected by 1.0 diopter. Increasing post-PRK central corneal thicknesses were associated with increased effects on MRSE.
Conclusions: :
The use of conductive keratoplasty for consecutive hyperopia after PRK is efficacious and safe, and the refractive changes are moderately stable and predictable. Further studies are needed to develop a surgical nomogram specific to corneas that have undergone ablative procedures. Long-term follow up studies are needed to determine the magnitude of regression over time.
Keywords: refractive surgery • hyperopia