193-nm Excimer Photorefractive Keratectomy in High Myopia

Neal A. Sher, David R. Hardten, Brad Fundingsland, Janet DeMarchi, Emmet Carpel, Donald J. Doughman, Stephen S. Lane, Charles Ostrov, Richard Eiferman, Jonathan M. Frantz, Jeffery Robin, William Telfair, Richard L. Lindstrom

Research output: Contribution to journalArticlepeer-review

117 Scopus citations


Purpose: To evaluate the refractive results of 193-nm excimer laser photorefractive keratectomy (PRK) performed on 48 highly myopic eyes in a multicenter study. Methods: A Visx 2015 or 2000 argon-fluoride excimer laser and a single-zone ablation technique were used. Postoperatively, eyes were treated with topical fluoromethalone for up to 5 months. Most eyes were treated with a 6.0- to 6.2-mm beam diameter after undercorrections and increased regression were noted with a 5.5 mm beam in earlier studies. Forty-eight eyes were treated for myopia, which was between −8.0 and −15.25 diopters (D) (spherical equivalent). The mean preoperative refraction was −11.2 D. Retreatment was performed after 6 to 16 months on 11 eyes for undercorrection. All eyes not retreated were followed for at least 12 months. Results: At 6 months, follow-up was available on 47 eyes. Of these eyes, 40% and 64% achieved corrections within 1 and 2 D of attempted correction, respectively. At 1 year, 60% of eyes attained 20/40 visual acuity or better uncorrected. Eleven patients (23%) were retreated between 6 to 16 months for undercorrection and/or regression. After retreatment, 47% and 81% of eyes achieved corrections within 1 and 2 D of attempted correction, respectively. At 1 year, 15% of eyes lost two lines of best-corrected visual acuity, and no eyes lost more than two lines. There was slightly more corneal haze seen in this group compared with the haze seen in patients undergoing PRK for low and moderate myopia. Conclusions: These data show that excimer PRK can correct high amounts of myopia with reasonable stability after 6 months. Excimer PRK is an effective surgical treatment of severe myopia, but long-term follow-up is still needed to assess the stability of its effect.

Original languageEnglish (US)
Pages (from-to)1575-1582
Number of pages8
Issue number9
StatePublished - 1994

Bibliographical note

Funding Information:
Supported in part by HealthSpan Co, Humana Co, and Visx Corporation. Dr. Sher is a paid consultant to the Visx Corporation and Ciba Vision Ophthalmic Company and owns stock in Visx and Summit Technologies, purchased on the open market. Dr. Telfair is an employee of Visx and is a stockholder. Reprint requests to Neal A. Sher, MD, Phillips Eye Institute, 2215 Park Ave, Minneapolis, MN 55404.


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