Repeat Versus Primary Photorefractive Keratectomy for Treatment of Myopia

Although effective, a portion of photorefractive keratectomy (PRK) patients will suffer residual myopia or relapse to myopic regression. This retrospective, non-randomized, comparative study, aimed to compare the efficacy of primary PRK versus PRK performed as retreatment after previous surgery for...

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Main Authors: Michael Mimouni, Arie Y. Nemet, Dror Ben Ephraim Noyman, Gilad Rabina, Avia Yossefi, Igor Kaiserman
Format: Article
Language:English
Published: MDPI AG 2024-11-01
Series:Optics
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Online Access:https://www.mdpi.com/2673-3269/5/4/36
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author Michael Mimouni
Arie Y. Nemet
Dror Ben Ephraim Noyman
Gilad Rabina
Avia Yossefi
Igor Kaiserman
author_facet Michael Mimouni
Arie Y. Nemet
Dror Ben Ephraim Noyman
Gilad Rabina
Avia Yossefi
Igor Kaiserman
author_sort Michael Mimouni
collection DOAJ
description Although effective, a portion of photorefractive keratectomy (PRK) patients will suffer residual myopia or relapse to myopic regression. This retrospective, non-randomized, comparative study, aimed to compare the efficacy of primary PRK versus PRK performed as retreatment after previous surgery for myopia. Data regarding the right eye of 220 consecutive myopic patients undergoing repeat or primary PRK in 2013–2017 were extracted. Groups were matched for demographics and preoperative spherical equivalent, sphere, astigmatism, uncorrected and corrected distance visual acuity (UDVA and CDVA). Primary outcomes were an efficacy index (ratio between the postoperative UDVA and the preoperative CDVA), a safety index (ratio between the postoperative and the preoperative CDVA), postoperative UDVA and CDVA, and deviation from target refraction. Primary PRK showed significant superiority in logMAR UDVA (0.01 ± 0.05 versus 0.05 ± 0.10, <i>p</i> = 0.001), logMAR CDVA (0.01 ± 0.05 versus 0.04 ± 0.08, <i>p</i> = 0.01), efficacy index (1.00 ± 0.05 versus 0.97 ± 0.09, <i>p</i> = 0.003) and safety index (1.00 ± 0.06 versus 0.98 ± 0.08, <i>p</i> = 0.04) compared to repeat PRK, but had a significantly higher share of patients with postoperative spherical equivalent (74.5% versus 67.3%) and cylinder (74.5% versus 68.2%) in the range of ±0.5 D. To conclude, enhancement PRK leads to inferior efficacy and safety with greater deviation from target refraction. Adjusted nomograms for repeat PRK may be warranted.
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spelling doaj-art-627c7a582d174da4aaeff3d619c4abd92025-08-20T02:57:28ZengMDPI AGOptics2673-32692024-11-015447748510.3390/opt5040036Repeat Versus Primary Photorefractive Keratectomy for Treatment of MyopiaMichael Mimouni0Arie Y. Nemet1Dror Ben Ephraim Noyman2Gilad Rabina3Avia Yossefi4Igor Kaiserman5Department of Ophthalmology, Rambam Health Care Campus, Haifa 3109601, IsraelDepartment of Ophthalmology, Meir Medical Center, Kfar Sava 4428164, IsraelDepartment of Ophthalmology, Rambam Health Care Campus, Haifa 3109601, IsraelSackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, IsraelBruce and Ruth Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa 3525433, IsraelCare-Vision Laser Centers, Tel Aviv 6407807, IsraelAlthough effective, a portion of photorefractive keratectomy (PRK) patients will suffer residual myopia or relapse to myopic regression. This retrospective, non-randomized, comparative study, aimed to compare the efficacy of primary PRK versus PRK performed as retreatment after previous surgery for myopia. Data regarding the right eye of 220 consecutive myopic patients undergoing repeat or primary PRK in 2013–2017 were extracted. Groups were matched for demographics and preoperative spherical equivalent, sphere, astigmatism, uncorrected and corrected distance visual acuity (UDVA and CDVA). Primary outcomes were an efficacy index (ratio between the postoperative UDVA and the preoperative CDVA), a safety index (ratio between the postoperative and the preoperative CDVA), postoperative UDVA and CDVA, and deviation from target refraction. Primary PRK showed significant superiority in logMAR UDVA (0.01 ± 0.05 versus 0.05 ± 0.10, <i>p</i> = 0.001), logMAR CDVA (0.01 ± 0.05 versus 0.04 ± 0.08, <i>p</i> = 0.01), efficacy index (1.00 ± 0.05 versus 0.97 ± 0.09, <i>p</i> = 0.003) and safety index (1.00 ± 0.06 versus 0.98 ± 0.08, <i>p</i> = 0.04) compared to repeat PRK, but had a significantly higher share of patients with postoperative spherical equivalent (74.5% versus 67.3%) and cylinder (74.5% versus 68.2%) in the range of ±0.5 D. To conclude, enhancement PRK leads to inferior efficacy and safety with greater deviation from target refraction. Adjusted nomograms for repeat PRK may be warranted.https://www.mdpi.com/2673-3269/5/4/36primary PRKmyopiarepeat PRKrefractive surgerycornea
spellingShingle Michael Mimouni
Arie Y. Nemet
Dror Ben Ephraim Noyman
Gilad Rabina
Avia Yossefi
Igor Kaiserman
Repeat Versus Primary Photorefractive Keratectomy for Treatment of Myopia
Optics
primary PRK
myopia
repeat PRK
refractive surgery
cornea
title Repeat Versus Primary Photorefractive Keratectomy for Treatment of Myopia
title_full Repeat Versus Primary Photorefractive Keratectomy for Treatment of Myopia
title_fullStr Repeat Versus Primary Photorefractive Keratectomy for Treatment of Myopia
title_full_unstemmed Repeat Versus Primary Photorefractive Keratectomy for Treatment of Myopia
title_short Repeat Versus Primary Photorefractive Keratectomy for Treatment of Myopia
title_sort repeat versus primary photorefractive keratectomy for treatment of myopia
topic primary PRK
myopia
repeat PRK
refractive surgery
cornea
url https://www.mdpi.com/2673-3269/5/4/36
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