Simultaneous aspheric wavefront-guided transepithelial photorefractive keratectomy and phototherapeutic keratectomy to correct aberrations and refractive errors after corneal surgery

PURPOSE: To evaluate the results of combined aspheric wavefront-guided transepithelial excimer laser photorefractive keratectomy (PRK) and phototherapeutic keratectomy (PTK) to correct aberrations and refractive errors after radial keratotomy (RK) or keratoplasty. SETTING: Sekal Rovigo Microsurgery Centre, Rovigo, Italy. METHODS: This retrospective noncomparative consecutive case series comprised eyes having corneal wavefront-guided transepithelial PRK to correct aberrations followed by PTK (60 to 70 mu m depth) without masking fluid. Corneal wavefront topography and a flying-spot excimer laser were used. Complete preoperative and postoperative ophthalmic examinations were performed. RESULTS: The mean age of the 26 patients (35 eyes; 17 RK, 18 keratoplasty) at surgery was 47 years +/- 9 (SD) (range 29 to 72 years) and the mean follow-up, 7 +/- 2 months (range 6 to 15 months). Preoperatively, all eyes had irregular astigmatism ranging from 0.50 to 6.50 diopters (D). At the last postoperative follow-up, the uncorrected distance visual acuity was better than 20/40 in 21 eyes (60%) and better than 20/20 in 6 eyes (17%); 25 eyes (71%) were within +/- 1.00 D of the attempted spherical equivalent manifest refraction (mean -0.58 +/- 1.06 D; range -3.50 to +1.50 D). No eye lost Snellen lines of corrected distance visual acuity; 8 eyes (23%) had an increase of more than 4 lines. Trace haze developed in 1 eye. CONCLUSION: Simultaneous corneal wavefront-guided transepithelial PRK and PTK using an excimer laser was safe and effective in correcting aberrations and refractive errors after RK or keratoplasty.