Astigmatism Research Today is a free monthly online journal that collates and summarizes the latest research about Astigmatism, including details on cornea, retina, treatment, types, signs, tests.

Photorefractive keratectomy with mitomycin C after deep anterior lamellar keratoplasty for keratoconus.

Leccisotti A

Ophthalmic Surgery Unit, Casa di Cura Rugani, Siena, Italy. leccisotti@libero.it

PURPOSE: To evaluate the safety and efficacy of photorefractive keratectomy (PRK) with intraoperative mitomycin C (MMC) after deep anterior lamellar keratoplasty (DALK) for keratoconus. METHODS: This was a prospective, noncomparative single-surgeon study. Eyes with compound myopic astigmatism after DALK with a spherical equivalent (SE) between -3 and -10 D were treated by PRK. After ablation, MMC 0.2 mg/mL was placed on the stromal bed for 45 seconds. A 6% undercorrection was planned. RESULTS: The study was completed on 10 eyes of 10 patients. The preoperative mean SE was -4.98 +/- 1.75 (SD) D. At 10 months after surgery, the mean SE was 0.28 +/- 0.61 D, and the mean defocus equivalent was 1.08 +/- 0.58 D. Postoperatively, 9 eyes were within 2 D, 6 were within 1 D, and 1 eye was within 0.5 D of defocus equivalent. The preoperative mean best spectacle-corrected visual acuity (BSCVA) was 0.68 +/- 0.15 D, and at 10 months it was 0.78 +/- 0.13 D. The 95% confidence interval for the mean difference of pre- and postoperative BSCVA was 0.02-0.17 (P < 0.05). No lines of BSCVA were lost. The mean postoperative uncorrected visual acuity was 0.55 +/- 0.1. The safety index was 1.15, and the efficacy index was 0.81. Corneal haze was grade 0 in 8 eyes and grade 0.5 in 2 eyes. Mean epithelialization time was 4.1 +/- 0.99 days. Preoperative mean endothelial cell density was 2320 +/- 184 cells/mm(2), and at 10 months it was 2284 +/- 175 cells/mm(2). CONCLUSIONS: PRK with MMC can safely and effectively correct myopia and regular myopic astigmatism after DALK. Undercorrection should be planned to compensate for the overcorrecting effect of MMC.

Published 24 April 2008 in Cornea, 27(4): 417-20.
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