The U.S. Army Surface Ablation Study: Comparison of PRK, MMC-PRK, and LASEK in Moderate to High Myopia

Sia, Rose K.; Ryan, Denise S.; Edwards, J. D.; Stutzman, Ray E.; Bower, Kraig S.

doi:10.3928/1081597x-20140320-04

Cited by 46 publications

(43 citation statements)

References 29 publications

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“…This eye was still highly myopic after the surgery (−8.00 D) and had not developed haze. Significant haze 6 weeks after surgery was not found in any cPRK eyes, but in 16 % of LASEK eyes, which is similar to other cPRK and LASEK findings [13,25,27]. Significant haze following cPRK has been reported, but only in studies using old generation excimer lasers [11,16].…”

Section: Discussionsupporting

confidence: 67%

“…Disadvantages of surface ablation techniques include a relatively long visual recovery period, postoperative pain, and higher risk of corneal haze and myopic regression as compared to intrastromal techniques, especially when treating high degrees of myopia [2,5,6,8,9]. Technological advancements with larger optical zones, corneal cooling, epithelial repositioning, mitomycin C, and highfrequency flying-spot excimer lasers with eye-trackers have improved outcomes and reduced the risk of complications after surface ablation techniques [3,7,[10][11][12][13][14][15][16]. The umbrella term for many of these improvements is "advanced surface ablation," which includes photorefractive keratectomy with cooling (cPRK) and laser-assisted subepithelial keratectomy (LASEK), among others [17].…”

Section: Introductionmentioning

confidence: 99%

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Four-year to seven-year outcomes of advanced surface ablation with excimer laser for high myopia

Hansen

Lyhne

Grauslund

et al. 2015

Graefes Arch Clin Exp Ophthalmol

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Section: Discussionsupporting

confidence: 67%

Section: Introductionmentioning

confidence: 99%

Four-year to seven-year outcomes of advanced surface ablation with excimer laser for high myopia

Hansen

Lyhne

Grauslund

et al. 2015

Graefes Arch Clin Exp Ophthalmol

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“…One year after surgery, there was no discernible difference in the postoperative refractive outcomes among the three methods. 28 Similarly, a prospective randomised controlled study showed MMC may not be needed to prevent haze after modern PRK with a four-month steroid taper. There was no clinically significant difference in haze formation between MMC eyes and control eyes at the concentration and exposures used.…”

Section: Mitomycin Cmentioning

confidence: 99%

“…35 Since then, it has been realised in randomised studies that the technique is not superior to conventional PRK in terms of patient comfort, reduction of haze or regression. 28 It seems that the manipulation of the epithelium would leave non-surviving cell and that the biological barrier of the replaced epithelial cells is insufficient to reduce a wound-healing response.…”

Section: Laser Subepithelial Keratomileusismentioning

confidence: 99%

Surface Ablation Techniques for Myopia – A Review of the Advances Over the Past 25 Years

Hjortdal¹

2017

European Ophthalmic Review

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Photorefractive keratectomy for correction of myopia was the first excimer laser-based technique to be developed. During the last 25 years, excimer lasers have improved technologically, several variations of the technique have been developed and pre-and postoperative pharmaceutical therapies have been investigated. This review article summarises these developments and the published meta-analyses on comparison of surface ablation techniques and laser in situ keratomileusis. The main conclusion is that there seem to be no differences between the clinical results obtained with the different variations of surface ablation techniques. KeywordsPhotorefractive keratectomy, laser in situ keratomileusis (LASIK), refractive surgical procedures, myopia, excimer laser Disclosure: Jesper Hjortdal discloses that Aarhus University Hospital has signed a research support agreement with Carl Zeiss Meditec, Jena Germany. No funding was received in the publication of this article. This study involves a review of the literature and did not involve any studies with human or animal subjects performed by any of the authors.Authorship: All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship of this manuscript, take responsibility for the integrity of the work as a whole, and have given final approval to the version to be published.Open Access: This article is published under the Creative Commons Attribution Noncommercial License, which permits any non-commercial use, distribution, adaptation and reproduction provided the original author(s) and source are given appropriate credit. When such a gas is put under electrical stimulation and high pressure, the excited compound can give up its excess energy by undergoing spontaneous emission, which very quickly (on the order of a picosecond) dissociates back into two unbound atoms. Directing the emitted light towards, for example, biological materials will result in ablation of surface molecules. In the early 1980s it was shown that using this approach biological materials, including the cornea, could be incised using the excimer laser.1-3 After short time, it was realised that actual surface ablation of the corneal stroma was possible after removal of the corneal epithelium 4 and that the resulting surface was very smooth. 5 In 1987, excimer laser-based keratotomy was performed in a human eye, 6 but it was the surface ablation application that pushed development of excimer lasers. 7,8 The first preliminary results in human eyes were published the late 1980s 9-12 and excimer lasers became commercially available around 1990. In the early 1990s larger follow-up series of patients undergoing PRK for myopia were published. [13][14][15] Since then, many modifications of PRK have been introduced, and a common uniting name for all these techniques is 'surface ablation'. This review will focus on surface ablation for myopia. Development of excimer lasersDirecting the location of the excimer laser rays is essential to change the surface shape of the ...

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“…Some prefer PRK because of the risk of post-LASIK ectasia, and some prefer phakic intraocular lens (PIOL) implantation due to the risk of corneal haze after PRK. [1][2][3] We designed a matched comparative study of patients with 48.0 diopters (D) of myopia and compared results of treatment with PRK and PIOL in these two groups. Our 1-year results 4 indicated that surface ablation and PIOL implantation correct uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), refraction, and astigmatism similarly, and they do not impact mesopic contrast sensitivity (CS).…”

Section: Introductionmentioning

confidence: 99%

Matched optical quality comparison of 3-year results of PRK–MMC and phakic IOL implantation in the correction of high myopia

Miraftab

Hashemi

Asgari

2015

Eye

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Aims To compare 3-year results of PRK-MMC and phakic intraocular lens (PIOL) implantation in patients with 48.0 diopters (D) of myopia. Methods This study was conducted as a non-randomized clinical trial on 23 eyes treated with PIOL (Artiflex; group A) and 23 eyes treated with PRK-MMC (group B). This report compares 3-year treatment results in these two groups.Results At 3 years after surgery, uncorrected visual acuity was 0.02 ± 0.06 LogMAR in group A and 0.04 ± 0.07 LogMAR in group B (P = 0.639). Mean best corrected visual acuity in group A (0.004 ± 0.02) was better than group B (0.03 ± 0.07 LogMAR) (P = 0.035). Mean manifest refraction spherical equivalent was − 0.16 ± 0.21 and − 0.09 ± 0.20D (P = 0.190), respectively. Mesopic contrast sensitivity (CS) in the spatial frequency of three cycle/degree (CS3) significantly decreased in both groups, but the reduction was significantly higher in group B (P = 0.024). CS6 decreased significantly only in group B (P = 0.019). Changes in CS12 and CS18 showed no significant inter-group difference. In group A, the increase in C6 trefoil (0.16 ± 0.18 μm, P = 0.003) and reduction in spherical aberration (SA; 0.16 ± 0.08 μm, Po0.001) were statistically significant. In group B, the reduction in vertical coma (P = 0.052), and increases in horizontal coma (P = 0.044), coma (Po0.001), SA (Po0.001), and total higher order aberrations (Po0.001) were significant after surgery. Conclusion Based on 3-year results, PIOL implantation is a better choice than PRK-MMC for treating patients with 48.0D myopia. However, for patients with an inadequate aqueous depth, PRK-MMC can be an acceptable treatment option with a potential for decreased quality of vision.

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The U.S. Army Surface Ablation Study: Comparison of PRK, MMC-PRK, and LASEK in Moderate to High Myopia

Abstract: MMC-PRK showed some benefits in minimizing corneal haze formation. One year after surgery, there was no discernible difference in the postoperative refractive outcomes among the three methods.

Cited by 46 publications

References 29 publications

Four-year to seven-year outcomes of advanced surface ablation with excimer laser for high myopia

Four-year to seven-year outcomes of advanced surface ablation with excimer laser for high myopia

Surface Ablation Techniques for Myopia – A Review of the Advances Over the Past 25 Years

Matched optical quality comparison of 3-year results of PRK–MMC and phakic IOL implantation in the correction of high myopia

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