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M. Chiaravalli, S. Donati, L. Venco, C. Azzolini; PRK Excimer Laser Treatments: Our Experience on Four Years Follow Up. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5326.
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To evaluate the efficacy, the safety and the stability of the PRK refractive treatment in low and moderate myopia and myopic mixed astigmatism.
204 eyes of 108 patients (mean age 33 yrs old), have been treated with PRK, in one eye and subsequently on the second eye within a month. At baseline mean sphere-equivalent refraction was -3,46 +-1.54 (min -1,00, max -6,00 D); patients were controlled within six month and had several follow up visits to a mean 48 months (from 46 to 56 months). At 48 month follow-up visit we evaluated the efficacy and safety of the treatment and its stability versus 6 month visit. Performed surgical technique firstly created a mechanical corneal disepithelization; treatment was carried out in controlled conditions with Excimer Laser Bausch&Lomb Technolas 217-C. We applied then a therapeutic contact lens on the first 7 days. Post treatment systemic analgesic therapy was prescribed for 5 days and dark sun glasses for 7 days.
No relevant complications were described in the short and in a long follow up. We report 21 cases of Haze 1-2 treated efficacely with medical treatment. No clinical relevant corneal ectasia or decentralization of the treatment of clinical relief were reported. A 6 months follow up UCVA was 1.0 or better in 70% treated eyes, 0.5 or better in 95% treated eyes, MRSE +/- 0,5 D in 80% treated eyes, MRSE +/- 1 D in 95% treated eyes. BCVA decrease more than 2 lines in 3.5% treated eyes, BCVA was < 0,5 in only 0.5% treated eyes. 78% treated eyes showed stability at the 48 month follow up. 60% treated eyes that showed regression have been retreated with PRK reporting a mean UCVA of 0.9.
Our study showed PRK as a safe and effective treatment for the correction of low and moderate myopia and miopic astigmatism. In our casuistry haze was reported as adverse event on moderate degree in only 10% treated eyes. Therapeutic corneal lens and a correct education of the patients allowed a good management of the immediately post-operative period. Only 15% of the treated eyes needed the substitution or the repositioning of the corneal lens. At the end of observation period we recorded an highest satisfaction coefficient from the patients related to the method (more of 90% reported to be disposed to repeat the laser treatment). No severe ocular pathologies as adverse events needing ocular surgery were reported.
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