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Epithelial Scrape for Photorefractive Keratectomy Overcorrection Associated with Induced Regression.

Kapadia, Manasvee S. M.D.; Genos, Jeffrey J. O.D.; Wilson, Steven E. M.D.
Article: ABSTRACT Only

Purpose: To study the effect of combined corneal epithelial scrape and contact lens wear treatment on regression in eyes with symptomatic overcorrection after photorefractive keratectomy (PRK) or PRK retreatment.

Methods: Fifteen eyes had corneal epithelial scrape with a scalpel followed by soft contact lens wear for approximately 1 month. Eight of the eyes were treated 3-4 months after the laser procedure, and seven eyes were treated >4 months after laser treatment. Fifteen eyes that had the same level of PRK correction and monitored during the same interval after PRK were used as matched control eyes.

Results: Epithelial scrape was performed for mean spherical equivalent (SE) of +1.1 +/- 0.4 diopters (D) (range, +0.50 to +1.75 D) at mean 6.1 +/- 3.2 months after PRK or PRK retreatment. The SE in these eyes was +0.5 +/- 0.6 D (range, -0.25 to +1.25 D) 3 months after epithelial scrape and +0.4 +/- 0.5 D (range, -0.75 to +1.25 D) 6 months after scrape. The change in scraped eyes at 3 and 6 months compared to before scrape was statistically significant (p = 0.001 and p = 0.001, respectively). The change in mean SE at 6 months after scrape (-0.7 +/- 0.5 D) was significantly different than the change noted in matched control eyes that were not scraped (-0.1 +/- 0.2 D) over the same interval after the PRK or PRK retreatment procedure. The change in SE at 6 months after epithelial scrape was greater for the eyes scraped 4 months or less (mean, 3.6 +/- 0.5 months) after PRK (-0.9 +/- 0.3 D) than eyes scraped >4 months (9.0 +/- 2.6 months) after PRK (-0.4 +/- 0.5 D). This difference approached statistical significance (p = 0.06).

Conclusions: Epithelial scrape and soft contact lens treatment for symptomatic overcorrection after PRK may induce regression and is more likely to be effective when performed <4 months after the primary PRK or PRK retreatment procedure.

(C) 1999 Lippincott Williams & Wilkins, Inc.