Corticosteroids for Reversal of Myopic Regression After Photorefractive Keratectomy

Reduction of corneal epithelial thickness during medical treatment for myopic regression following FS-LASIK

Background

To evaluate corneal epithelial thickness change during medical treatment for eyes with myopic regression after femtosecond laser-assisted in situ keratomileusis (FS-LASIK).

Methods

This study included 84 eyes of 54 subjects diagnosed with myopic regression after FS-LASIK and treated using topical steroid and anti-glaucoma drugs. Corneal epithelial thickness was measured using Fourier-domain optical coherence tomography before and after treatment. Subjects were divided into three groups based on their corneal epithelial thickness at the time of myopic regression and regression analyses were used to investigate the association between corneal epithelial thickness, visual acuity, and refraction. Logistic regression and receiver operating characteristic (ROC) curve analysis was performed to determine whether corneal epithelial thickness could predict the success of treatment, improvements of ≥ two lines in uncorrected distance visual acuity and ≥ 0.5 diopter in refraction or K.

Results

Corneal epithelial thickness decreased with greater change in the center as myopic regression subsided during medical treatment. Subgroup with the thickest epithelium (≥ 62 μm) showed a higher success rate and greater changes in refraction and vision. Reduced magnitude of corneal epithelial thickness showed significant correlations with changes of K and refractive error (all P < 0.001). Corneal epithelial thickness was a significant factor for the success of treatment and ROC curve showed that corneal epithelial thickness > 60.50 μm had 81.5% sensitivity and 84.2% specificity for the success of medical treatment.

Conclusion

Corneal epithelial thickness decreases proportionally with the magnitude of improvement of myopic regression during treatment with steroid and anti-glaucoma drugs in post-LASIK eyes with myopic regression.

Advances in refractive surgery: 1975 to the present

PURPOSE

To review the major advances in the field of refractive surgery occurring over the past 25 years.

METHODS

Literature review.

RESULTS

The major developments in refractive surgery over the past 25 years are reviewed.

CONCLUSIONS

The past 25 years have witnessed great changes in refractive surgery. As a result of advancements in technology, instrumentation, and technique, we have seen improvements in the treatment of all types of ametropias. In this article, we review some of the successes and failures of the past quarter-century.

Retreatment of Regression after Photorefractive Keratectomy for Myopia

PURPOSE

To study results of retreatment after regression in myopic patients who underwent photorefractive keratectomy (PRK).

METHODS

Procedures were performed with the Nidek EC-5000 excimer laser. This was a retrospective study of 20 of 2127 patients, with follow-up of at least 6 months, who underwent repeated excimer laser ablation.

RESULTS

No patient with low myopia had regression. We evaluated six eyes (group I) with moderate myopia; 13 eyes (group II) with high myopia; and ten eyes (group III) with extreme myopia. Average uncorrected visual acuity at 6 months after retreatment was 0.73 +/- 0.21 in group I, 0.64 +/- 0.35 in group II, and 0.61 +/- 0.38 in group III. At six months after retreatment, the average was -0.36 +/- 1.05 D in group I, -0.42 +/- 1.12 D in group II, and -1.40 +/- 1.62 D in group III.

CONCLUSION

The amount and frequency of regression was higher in patients with high and extreme myopia; however, the preliminary results of retreatment of regression were satisfactory.