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D. S. Landmann, J. L. Stejna, Jr., W. A. Allam, H. K. Wu; Conductive Keratoplasty for Consecutive Hyperopia After Photorefractive Keratectomy. Invest. Ophthalmol. Vis. Sci. 2009;50(13):3979.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the efficacy, predictability and refractive stability of conductive keratoplasty (CK) after photorefractive keratectomy (PRK) for consecutive hyperopia.
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.
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.
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.
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