Making Laser Surgery Safer for RK Patients

Nov 12, 2007, 00:00 ET from American Academy of Ophthalmology

    NEW ORLEANS, Nov. 12 /PRNewswire/ -- A new study being presented at the
 American Academy of Ophthalmology's 2007 Annual Meeting suggests that the
 laser surgery can help improve and possibly stabilize the vision of
 patients who have radial keratomy (RK) while preventing previously common
 side effects from the surgery.
     In the study, 22 patients who had previously undergone RK and
 subsequently developed unanticipated changes in prescriptions for
 correcting vision underwent advanced surface ablation with miomycin C, an
 anti-scarring medication. Most patients experienced a significant
 improvement in corrected and uncorrected vision without any complications.
     "This gives new hope to patients who have had RK and have developed
 problems," said Navaneet Borisuth, MD, Ph.D., the presenting author of the
 poster. "Most refractive surgeons would shy away from these patients
 because we were not able to deliver the results that they expected. Now,
 with this refinement, we can deliver a very good quality of vision for our
 RK patients."
     Before the advent of laser surgery, RK was the predominant method of
 surgically correcting nearsightedness in patients. The procedure involved a
 surgeon making small incisions in the cornea, thus relaxing it and
 flattening it, which in turn corrected myopia. However, some patients
 developed farsightedness, or hyperopia, as scarring around the incisions
 caused the cornea to tighten and further change its shape. Efforts to
 correct this problem with laser technologies, such as photorefractive
 keratectomy (PRK) or LASIK, were fraught with complications and were often
     "The problem with PRK was patients would develop haze, which is a type
 of scarring response on the cornea and which could result in worse vision
 than the vision that the patient started out with," said Dr. Borisuth.
     Dr. Borisuth and co-author Prem Virdi, MD, treated 16 patients with
 LASEK and 6 with EpiLASIK for refractive error. The patients had had as
 many as 16 incisions made on the cornea with RK. After the most recent
 treatment, the doctors applied mitomycin C for 12 seconds and then assessed
 the results.
     "Basically, all the patients had a significant improvement in
 uncorrected vision, and in terms of corrected vision, 95.5 percent of the
 patients were within one diopter of what we were aiming for," Dr. Borisuth
 said. "No patient had vision worse than 20/25." One patient did experience
 haze as a complication from EpiLASIK.
     Further long-term studies are necessary to confirm the benefits of the
 approach. Nonetheless, the study suggests that RK patients may have
 surgical options that they previously did not. "These refinements do
 represent a safe way of treating refractive error in patients after RK,"
 Dr. Borisuth said.
     About the American Academy of Ophthalmology
     The American Academy of Ophthalmology is the world's largest
 association of eye physicians and surgeons -- Eye M.D.s -- with more than
 27,000 members worldwide. Eye health care is provided by the three "O's" --
 opticians, optometrists and ophthalmologists. It is the ophthalmologist, or
 Eye M.D., who can treat it all: eye diseases and injuries, and perform eye
 surgery. To find an Eye M.D. in your area, visit the Academy's Web site at

SOURCE American Academy of Ophthalmology