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BACKGROUND: The therapeutic mode of the VISX 20/20 excimer laser was used to remove the corneal epithelium prior to performing photorefractive keratectomy (PRK) with a multizone, multipass technique. METHODS: A retrospective analysis was performed of 120 eyes of 90 patients that were treated for preoperative spherical refractive errors from -1.00 to -7.00 diopters (D) (mean -3.90 D, SD 1.54) by one surgeon (DGJ) over 7 months. RESULTS: Six-month follow-up was obtained in 76 eyes (63%). Sixty-nine eyes (91%) achieved a spherical equivalent refraction within ±1.00 D of emmetropia. Regression of effect averaged -0.35 D (SD 0.53 D) from 1 to 6 months after surgery. Mean postoperative uncorrected visual acuity at 6 months was 20/25 (range 20/15 to 20/200). Seventythree eyes (96%) achieved uncorrected visual acuity of 20/40 or better, 67 (88%) achieved uncorrected visual acuity of 20/25 or better, and 76 (71%) achieved 20/20 or better. Three eyes (4%) lost one line of spectacle-corrected visual acuity; no eye lost more than one line. There were no significant surgical complications. CONCLUSION: Removal of corneal epithelium with the Summit Excimed UV 200 LA excimer laser using multizone, multipass photoablation yields visual and refractive results that compare favorably with published PRK series with excellent short-term stability. [J Refract Surg 1998;14:38-48]

T-hex keratotomy surgically corrects manifest hyperopia. The typical patient presenting for this surgery is a presbyope who develops symptoms from latent hyperopia. These patients are older than typical radial keratotomy patients and are thus likely to develop senile cataracts sooner. The exact surgical approach to cataract surgery in such patients is unknown. We report a patient who had successful cataract extraction by phacoemulsification with implantation of a posterior chamber lens after a previous routine T-hex keratotomy. The preoperative workup and the surgical technique did not require modification.

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