Wavefront-Guided Photorefractive Keratectomy in Complicated Patients with History of Radial Keratotomy: A Clinical Trial

Notwithstanding the fact that Radial keratotomy (RK) is now a neglected surgical method, patients and ophthalmologists are still dealing with its following complications such as hyperopic shift. This study was sought to assess the results and benefits of Photorefractive keratectomy (PRK) in complicated patients who had RK procedure in their clinical history.

This non-controlled clinical trial was carried out on 20 eyes pertaining to 17 patients with history of RK and presenting with significant refractive problems. All patients undergone Wavefront-guided (WG) PRK with Mitomycin-C and were followed for at least three months. Uncorrected distance visual acuity (UDVA), Corrected distance visual acuity (CDVA), total aberration, high order (HO) aberration and complications were compared between the status of patients before and after the procedure.

UDVA was averagely improved about 3 lines (P < 0.001). After the procedure 100% and 50% of subjects had visual acuity of ≥ 4.10 and ≥ 7.10, respectively, while; such frequencies prior to the procedure were about 55% and 0%, respectively. Moreover, 40% and 100% were at the idealistic refraction status of 1 D and 1.75 D, respectively. None of 20 subjects had decline of CDVA. Total aberrations were significantly decreased (P < 0.001) although changes of HO aberrations did not achieve significance level (P = 0.33) Three subjects manifested corneal opacity following PRK (two with grade II and one with grade I).

WG PRK has benefit in most of the cases and our current experience indicates the value of WG PRK in patients with history of RK.