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P. Sivelli, E. Cavalli, A. Galli, S. Donati, P. Chelazzi, R. Marchesi, L. Marino, C. Azzolini; Photorefractive Keratectomy Using an Excimer Laser For Post-Penetrating Keratoplasty Elevated Astigmatism. Invest. Ophthalmol. Vis. Sci. 2010;51(13):4214.
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To determine the efficacy of a customized photorefractive keratectomy (PRK) in patients with post-penetrating keratoplasty (PKP) astigmatism.
20 eyes of 20 patients (12 males and 8 females) were included in the study. All patients underwent penetrating keratoplasty at least two years before to be included in the study. We divided patients into two Groups: 7 eyes (Group 1) underwent aberrometry customized photorefractive treatment, 13 eyes (Group 2) underwent a standard PRK. Before surgery all patients underwent ocular examination including corneal topography and aberrometry (Orbscan IIz, Bausch&Lomb), and pachimetry. Topography revealed a mean astigmatism of 3,25 ± 4,04 D and mean corneal pachimetry was 532 ± 29 µm. We performed PRK and LASEK surgery with an excimer laser (Zyoptix 217z100 Technolas Bausch&Lomb). Complete ocular examination was performed during 12 months’ follow up.
In Group 1 we measured at baseline a mean visual acuity of 0.9 LogMAR, at month 3 0.53 LogMAR, at month 9 0.18 LogMAR. In Group 2 we measured at baseline a mean visual acuity of 0.87 LogMAR, at month 3 0.51 LogMAR, at month 9 0.12 LogMAR. At the end of follow-up time the variation of visual acuity between Group 1 and Group 2 was not statistically significant (p>0.05).
Customized PRK didn’t show a significant better result compared to standard PRK, probably due to the not decisive role of aberrometry in the grafted eye. However, customized treatment on PKP technique revealed its worth as effective tool to reduce surgical induced astigmatism after penetrating corneal transplantation.
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