Efficacy and safety of excimer laser photorefractive keratectomy and radial keratotomy for bilateral myopia

Abstract

To compare the safety and efficacy of radial keratotomy (RK) and photorefractive keratectomy (PRK) to correct myopia. In this randomized, prospective, parallel-group study, 33 patients with bilateral myopia of 1.00 to 5.00 diopters (D) had PRK in one eye and RK in the other. The order of surgeries and treatment assignments were randomized, and the bilateral surgeries were within 1 week for each patient. Data were collected using standardized procedures. Clinical measurements and satisfaction surveys were taken in masked fashion. Eyes that had PRK had statistically significantly more residual myopia than RK-treated eyes at 3, 6, and 12 months postoperatively. This result was attributed to the use of an older excimer laser PRK algorithm that was used at the initiation of the study. No eye that had PRK was overcorrected by 0.50 D or more at 1 year postoperatively, while seven eyes that had RK were overcorrected by at least 0.50 D and six were overcorrected by 1.00 D. Eyes that had PRK had a statistically significant mean shift in the myopic direction between 6 and 12 months postoperatively; two RK eyes had hyperopic shifts of 1.00 D. Three RK eyes and two PRK eyes failed to achieve an uncorrected visual acuity of 20/40 or better by 12 months postoperatively. No eye lost any best corrected visual acuity. The two procedures were comparably safe and effective in treating mild to moderate myopia under this protocol. Eyes that had PRK were somewhat more myopic at 1 year after surgery, attributable to the older PRK ablation algorithm. Adoption of newer (current) laser algorithms has improved the predictability of PRK. There was also evidence of reduced variability of outcome in the PRK group. The PRK eyes did not exhibit hyperopic shifts during the 1 year follow-up.