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November 1994

One-Year Results of Excimer Laser Photorefractive Keratectomy for Low to Moderate Myopia

Author Affiliations

From the New England Eye Center, Tufts University School of Medicine (Drs Dutt, Raizman, and Puliafito) and the Center for Eye Research, Ophthalmic Consultants of Boston (Mass) (Dr Steinert). Dr Steinert is the phase III Medical Monitor for Summit Technology. Dr Puliafito is a paid consultant to Summit Technology. Drs Dutt and Raizman have no commercial proprietary interest in the Summit excimer laser or Summit Technology, Waltham, Mass.

Arch Ophthalmol. 1994;112(11):1427-1436. doi:10.1001/archopht.1994.01090230041018

Objective:  Excimer photorefractive keratectomy is a promising method to reduce myopia. We evaluated the effectiveness, predictability, stability, and safety of photorefractive keratectomy performed by two surgeons at a single site with a 1-year follow-up.

Methods:  An excimer laser (Summit Excimed UV200, Summit Technology, Waltham, Mass) was used to treat 47 eyes. Preoperative uncorrected visual acuity averaged 20/277 and ranged from 20/60 to 20/500. Spherical equivalent averaged −3.9 diopters and ranged from −1.5 to −6.1 D.

Results:  One year postoperatively, best corrected visual acuity averaged 20/13 and ranged from 20/10 to 20/20. No patients lost any of best corrected visual acuity. The uncorrected visual acuity at 1 year averaged 20/20 and ranged from 20/10 to 20/200. Ninety-four percent of eyes had an uncorrected visual acuity of 20/40 or better; 83%, 20/25 or better; and 74%, 20/20 or better. An initial hyperopic overcorrection is followed by gradual regression to emmetropia during a 12-month period. Refractive spherical equivalent averaged 0.44 D and ranged from −3 to +2.6 D at 1 year. The proportion of eyes within I D of emmetropia was 80% at 1 year. The most significant shifts in refraction occurred between the first and second months, but small shifts occurred up to 12 months. Subgrouping the results according to age revealed a significantly greater effect with larger residual hyperopia in those older than 40 years. Patient satisfaction with the procedure was high.

Conclusion:  During a 1-year period, excimer photorefractive keratectomy appears to be an effective, predictable, stable, and safe method to reduce myopia. Age may play a role in the effectiveness of the procedure, with greater hyperopia resulting in those older than 40 years.