Titre du document / Document title

Photorefractive keratectomy for compound myopic astigmatism

Auteur(s) / Author(s)

HAW Weldon W. ⁽¹⁾ ; MANCHE Edward E. ⁽¹⁾ ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Stanford University School of Medicine, Stanford, California, ETATS-UNIS

Résumé / Abstract

○ PURPOSE: To evaluate the safety and efficacy of photorefractive keratectomy for the treatment of primary compound myopic astigmatism. ○ METHODS: In a prospective study, 93 eyes from 56 patients with a mean spherical equivalent of -4.98 ± 1.80 diopters (range, -1.75 to -8.5) underwent photoastigmatic refractive keratectomy with the Summit Apex Plus excimer laser using erodible mask technology and were followed for 2 years. Primary outcome measures included an assessment of astigmatic correction through vector analysis, manifest refraction, uncorrected visual acuity, corneal clarity, and the presence of adverse symptoms. ○ RESULTS: Eighty-five eyes (91.4%) were available for analysis at 6 months. Mean spherical equivalent refraction was reduced 85% (mean, -0.75 ± 0.85 diopter) and the target-induced astigmatism was reduced 70% (mean, 0.98 ± 1.88 diopters). Forty-eight eyes (56%) had an uncorrected visual acuity of 20/20 or greater, whereas 70 eyes (82%) had an uncorrected visual acuity of 20/40 or greater. Twenty-four eyes (26% ) required re-treatment because of undercorrection of the spherical equivalent and astigmatic components after the 6-month follow-up. Fifty-nine of the remaining eyes were available at the 24-month visit. Mean spherical equivalent refraction was reduced to -0.39 ± 0.72 diopter (91.8%). The target-induced astigmatism was reduced 64% from 1.74 diopters. Forty-one eyes (81.3%) were within ±1.0 diopter of attempted spherical equivalent correction. Stability within a spherical equivalent of ±0.5 diopter occurred after the first postoperative month. Fifty-six eyes (94.9%) had an uncorrected visual acuity of 20/40 or greater, whereas 34 eyes (57.6 %) demonstrated an uncorrected visual acuity of 20/20 or greater. One eye (1.7%) lost 2 or more lines of best spectacle-corrected visual acuity. ○ CONCLUSION: Photoastigmatic refractive keratectomy with the Summit Apex Plus excimer laser is a safe and effective method of reducing compound myopic astigmatism. However, higher re-treatment rates may result from significant undercorrections because of current laser algorithms and variability in the mean angle of error.

Revue / Journal Title

American journal of ophthalmology   ISSN 0002-9394   CODEN AJOPAA 

Source / Source

2000, vol. 130, n^o1, pp. 12-19 (25 ref.)

Langue / Language

Anglais

Editeur / Publisher

Elsevier, New York, NY, ETATS-UNIS  (1884) (Revue)

Mots-clés anglais / English Keywords

Photorefractive keratectomy ; Laser ; Excimer ; Astigmatism ; Treatment ; Treatment efficiency ; Myopia ; Safety ; Human ; Surgery ; Eye disease ; Vision disorder ; Refractive error ;

Mots-clés français / French Keywords

Kératectomie photoréfractive ; Laser ; Excimère ; Astigmatisme ; Traitement ; Efficacité traitement ; Myopie ; Sécurité ; Homme ; Chirurgie ; Oeil pathologie ; Trouble vision ; Trouble réfraction oculaire ;

Mots-clés espagnols / Spanish Keywords

Queratectomía fotorefractiva ; Laser ; Excímero ; Astigmatismo ; Tratamiento ; Eficacia tratamiento ; Miopía ; Seguridad ; Hombre ; Cirugía ; Ojo patología ; Trastorno visión ; Trastorno refracción ocular ;

Localisation / Location

INIST-CNRS, Cote INIST : 2012, 35400009136491.0020