Corneal indices following photorefractive keratectomy in children at least 5 years after surgery

Abstract Purpose To evaluate long-term corneal outcomes in pediatric patients who underwent photorefractive keratotomy (PRK) for the treatment of refractive amblyopia. Methods In this prospective interventional case series, children with refractive amblyopia underwent PRK between January 1, 2007, and December 31, 2011, at Texas Children’s Hospital’s Department of Ophthalmology, a single tertiary eye center, and were followed for at least 5 years after surgery. Main outcome measures were 5+ years postoperative indices of corneal thickness, keratometry, degree of corneal haze, and presence or absence of keratectasia. Results Twelve eyes of 8 subjects aged 3-9 years who underwent PRK and were followed for at least 5 years were included. The mean PRK treatment dose was 8.46 D for the myopic cohort and 4.49 D for the hyperopic cohort, which removed an average of 72 μm of corneal stromal tissue in addition to the 50 μm of corneal epithelium that was removed prior to laser ablation. The mean corneal thickness was 563 μm preoperatively, which decreased to 441 μm immediately following the PRK. The mean corneal thickness 5+ years after PRK was stable, at 498 μm, because of epithelial regrowth. None of the subjects developed visually significant corneal haze or topographic evidence of keratectasia. Conclusions In this study cohort, there were no topographic signs of keratectasia or corneal haze in children treated with PRK for high refractive error 5 years or more after surgery.