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Photorefractive keratectomy with mitomycin C after corneal transplantation

Session Details

Session Title: Surface Ablation II

Session Date/Time: Tuesday 08/10/2013 | 16:30-18:00

Paper Time: 17:45

Venue: Main Lecture Hall (Ground Floor)

First Author: : M.Rego PORTUGAL

Co Author(s): :    I. Laķns   P. Cardoso   E. Costa   A. Rosa   M. Quadrado   J.

Abstract Details

Purpose:

To evaluate the results of photorefractive keratectomy (PRK) to treat high ametropia and irregular astigmatism after corneal transplantation

Setting:

Ophthalmology Department, Centro Hospitalar e Universitįrio de Coimbra, Portugal; Faculty of Medicine, University of Coimbra, Portugal

Methods:

Retrospective study evaluating patients submitted to PRK (Allegretto Wave® Eye-Q, Wavelight®, Erlangen, Germany) after corneal transplantation, from July 2008 to January 2013. Surgery was performed when refractive stability was achieved and at least 6 months after suture removal. PRK was followed by mitomycin-C 0.02% application for 15 to 30 seconds, depending on the depth of ablation. The type of treatment depended on corneal irregularity. In the presence of irregular astigmatism, the ablation was guided by topography (T-CAT profile). Minimum follow-up was 3 months

Results:

Twenty-three eyes of 21 patients (12 women and 9 men) with mean age of 48.19 years (SD±14.06) were included. Keratoconus was the most common cause for transplantation (15 eyes). PRK was done 9.86 years (SD±6.74, from 2 to 20) after corneal transplantation. Topography-guided PRK was performed in 15 eyes and wavefront-optimized PRK in 8 eyes. Best correct visual acuity (BCVA) improved from 0.18 (SD±0.17) pre-operatively to 0.11 (SD±0.18) logMAR at 14 months (SD±10.18, from 3 to 52) after surgery and uncorrected visual acuity (UCVA) improved from 0.9 (SD±0.34) to 0.33 (SD±0.32) logMAR. In the topography-guided PRK group, the BCVA improved from 0.24 (SD±0.19) to 0.11 (SD±0.20) logMAR but in wavefront-optimized group the BCVA did not improve significantly [0.09 (SD±0.08) pre-operative and 0.10 (SD±0.14) logMAR post-operative]. The pre-operative sphere ranged from -4 to +5D and from -2 to +1D post-operatively. The refractive cylinder ranged from -9 to +6D before surgery and decreased to -4 to +3D at 6 month after surgery. There was no significant change in corneal endothelial cell density

Conclusions:

Topography-guided PRK with mitomycin-C is able to correct irregular astigmatism after corneal transplantation with a significant improvement in BCVA. Wavefront-optimized PRK corrects high ametropias, improving UCVA. Both treatments proved to be effective and safe in corneal transplantation

Financial Interest:

NONE