Excimer laser photorefractive keratectomy for high myopia

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Abstract
One hundred and thirty-three eyes of 103 patients had photorefractive keratectomy with a slit scan mode excimer laser for myopia ranging from −6.00 to −22.00 diopters (D). The epithelium was removed with 20% ethanol, and the ablation was done with a tapered profile surrounding the optical zone. Patients were divided into two groups based on preoperative myopia: Group A, −6.00 D to −12.00 D (88 eyes); Group B, −12.50 D to −22.00 D (45 eyes). In Group A, mean preoperative refraction was −9.59 ± 1.79 D. Mean postoperative refraction was −0.29 ± 1.47 D at one month, −0.85 ± 1.68 D at three months, −1.17 ± 2.04 D at six months, and −0.56 ± 0.74 D at one year. Anterior stromal haze was greatest at the end of the first month; it diminished thereafter. This haze did not reduce the best corrected visual acuity in any eye in Group A. Mean preoperative refraction in Group B was −14.69 ± 5.27 D. Mean postoperative refraction was −1.34 ± 2.02 D at one month, −0.76 ± 2.08 D at three months, −3.88 ± 2.32 D at six months, and −5.50 ± 5.00 D at one year. Three eyes in Group B lost one or two lines of best corrected visual acuity as a result of severe stromal haze and epithelial scarring. Group A’s results were similar to those obtained in eyes with low myopia. In Group B, although a percentage of eyes obtained fairly good results, the lower degree of predictability and large variation in the results suggest that using this technique is unadvisable in eyes with extremely high myopia except in selected cases.

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