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Excimer Laser Photorefractive Keratectomy in High MyopiaA Multicenter Study
Neal A. Sher, MD;
Mark Barak, MD;
Sheraz Daya, MD;
Janet DeMarchi, COT;
Angela Tucci;
David R. Hardten, MD;
Jonathan M. Frantz, MD;
Richard A. Eiferman, MD;
Paula Parker, COMT;
William B. Telfair III, PhD;
Stephen S. Lane, MD;
Richard L. Lindstrom, MD
Arch Ophthalmol. 1992;110(7):935-943.
Abstract
• Excimer photorefractive keratectomy was performed at three centers on 16 highly myopic eyes (8 diopters [D] or more) and followed up for 6 months. Ablation depths ranged from 137 to 230 µm. The preoperative spherical equivalent of myopia ranged from –8.62 D to –14.50 D (mean±SD, –11.57±1.62 D). Six months after surgery, the mean refraction (spherical equivalent) was –0.90±2.1 D. Eleven of 16 eyes achieved refractions within 2 D of that attempted. All eight patients at one site were treated with a maximum-beam diameter of 6.0 mm and were corrected to within 2 D of that attempted, and all were 20/40 or better uncorrected. Three of eight eyes at the other two sites were treated with a 5.5- or 5.6-mm maximum-beam diameter, which achieved corrections within 2 D of that attempted. The epithelium healed within 3 to 4 days, and there were no erosions. Mild subepithelial reticular haze, similar to that seen with excimer photorefractive keratectomy for lower myopia, was seen in all patients, with two patients experiencing more significant corneal haze. This peaked at 3 to 6 weeks and then gradually diminished. All but two patients had a return of their best corrected preoperative visual acuity to within one Snellen line at 6 months. This preliminary study shows excimer photorefractive keratectomy to be a promising surgical treatment for patients with higher myopia.
Author Affiliations
From the Excimer Research Group, Phillips Eye Institute, Minneapolis, Minn, and the Department of Ophthalmology, University of Minnesota Medical School, Minneapolis (Drs Sher, Barak, Daya, Hardten, Lane, and Lindstrom, and Mss DeMarchi and Parker); the Eye Center of Florida, Fort Myers (Dr Frantz); the Department of Ophthalmology, University of Louisville, Ky, and Veterans Affairs Medical Center, Louisville (Dr Eiferman); and VISX Co, Sunnyvale, Calif (Dr Telfair and Ms Tucci). Dr Sher owns stock in VISX Co (purchased on the open market), and Dr Telfair and Ms Tucci are employees of the VISX Co. The other authors have no financial interest in VISX Co or in any products mentioned in this article.
Footnotes
Accepted for publication April 22, 1992.
Presented in part at the American Society for Cataract and Refractive Surgery, San Diego, Calif, April 14, 1992, and at the Association for Research in Vision and Ophthalmology, Sarasota, Fla, May 4, 1992.
Reprint requests to Phillips Eye Institute, 2215 Park Ave S, Minneapolis, MN 55404 (Dr Sher).
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