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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.

From the Eye Institute and Department of Cell Biology, The Cleveland Clinic Foundation, Cleveland, Ohio (M.S.K., J.J.G., S.E.W.), and the Department of Ophthalmology, University of Washington School of Medicine, Seattle, Washington (S.E.W.), U.S.A.

Address correspondence to Dr. S.E. Wilson, Department of Ophthalmology, Box 356485, University of Washington School of Medicine, Seattle, WA 98195-6485, U.S.A. E-mail: sewilson@u.washington.edu

Submitted December 22, 1998. Revision received February 27, 1999. Accepted March 5, 1999.

© 1999 Lippincott Williams & Wilkins, Inc.