Journal
CORNEA
Volume 22, Issue 5, Pages 399-404Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/00003226-200307000-00002
Keywords
laser in situ keratomileusis; flap complications; phototherapeutic keratectomy; photorefractive keratectomy
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Purpose. To present the results of photorefractive keratectomy (PRK) for treatment of laser in situ keratomileusis (LASIK) flap complications. Methods. Compilation of case reports through solicitation on Kera-net, an Internet surgery discussion site. Results. PRK was performed on 13 patients from 2 weeks to 6 months after LASIK flap complications. The technique used for the PRK varied. Epithelial removal was per-formed using no-touch phototherapeutic keratectomy (PTK) in six of the 13 patients and manual debridement in the other seven patients. A dilute solution of 20% ethanol was used to facilitate manual debridement in five of the seven patients. In two of these five patients, the epithelium was replaced as in laser-assisted subepithelial keratomileusis (LASEK). A solution of 0.02% mitomycin C was used after laser ablation to prevent haze formation in three patients. After an average 7 months of follow-up, uncorrected visual acuity was 20/20 in six patients, 20/25 in four patients, and 20/30 in two patients. The visual acuity in one patient was 20/80, purposely left under-corrected for monovision. Best spectacle-corrected visual acuity was 20/20 in 10 of 13 patients. Three patients were 20/25, losing one line of best spectacle-corrected visual acuity. On slit-lamp examination. at last follow-up appointment, stromal haze was graded from trace to none in all patients. Conclusions. Photorefractive keratectomy is a safe and effective technique for treatment of patients with LASIK flap complications.
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