Excimer laser photorefractive keratectomy to correct astigmatism.

PURPOSE: To evaluate the efficacy of excimer laser photorefractive keratectomy (PRK) to correct astigmatism. SETTING: Hôpital Morvan, Brest, France. METHODS: A 193 nm excimer laser was used to perform toric ablation with an expanding slit to flatten the cornea in the steeper meridian and/or to correct myopia with an iris diaphragm in 72 eyes (55 patients): 68 eyes for compound myopic astigmatism and 4 for astigmatism only. RESULTS: Preoperative cylinder was -2.14 diopters (D) +/- 1.99 (SD) (range -0.50 to -5.50 D); 6 months postoperatively, it was -1.75 +/- 1.34 D (range -0.25 to -5.25 D). Preoperative spherical equivalent was -5.33 +/- 3.22 D (range -0.25 to -14.50 D); 6 months postoperatively, it was -0.86 +/- 2.32 D (range 2.50 to -9.75 D). The axial error was within 30 degrees. Uncorrected visual acuity was 0.50 or better in 64.5% of patients. CONCLUSIONS: Overall patient satisfaction seemed the result of the myopic correction; cylindrical correction was incomplete. Future software refinements should improve the results. In particular, single elliptical ablation seems to offer theoretical advantages.

Myopic photorefractive keratectomy in eyes with atypical inferior corneal steepening.

PURPOSE: To evaluate the visual and refractive results of photorefractive keratectomy (PRK) in eyes with atypical inferior corneal steepening (AICS). SETTING: Department of Ophthalmology, Hôpital Morvan, University of Breast, France. METHODS: Using videokeratopography, we screened 310 eyes that had PRK from November 1992 through November 1993 and found that 35 eyes exhibited topographic patterns consistent with AICS with no clinical findings. The results at 6 months and 1 year were compared with those of 185 eyes with normal topography treated concurrently. RESULTS: There were no statistically significant differences between the two groups in mean spherical equivalent, mean uncorrected visual acuity, and mean best spectacle-corrected visual acuity 6 months and 1 year after PRK. CONCLUSION: After 1 year, PRK in eyes with AICS appeared to give results similar to those in eyes with normal topography. Further follow-up is needed.

Clinical results of excimer laser photorefractive keratectomy: a multicenter study of 265 eyes.

Efficacy, predictability, and safety of excimer laser photorefractive keratectomy were evaluated at centers in Paris and Brest, France. Photoablation was performed with the VISX laser on 265 eyes (151 at the Paris center and 114 at the Brest center). The eyes were clinically and statistically evaluated over a six month follow-up. Initial myopia ranged from -0.7 to -19.4 diopters (D) (mean spherical equivalent [SE] -5.9 D) in the Paris center and from -0.9 to -14.5 D (SE -4.5 D) in the Brest center. At both centers, the mean uncorrected visual acuity was worse than 20/200; over 90% of cases in each center had a best uncorrected visual acuity of 20/100 or worse. Results are reported globally and for subgroups of myopia: Group A, SE better than or equal to -3.0 D; Group B, SE worse than -3.0 D and better than or equal to -7.0 D; Group C, SE worse than -7.0 D. Uncorrected visual acuity was significantly improved in the patients followed for six months; 64% of Paris cases and 62% of Brest cases obtained an uncorrected visual acuity of 20/40 or better. Predictability of the treatment was good; 67% of Paris eyes and 74% of Brest eyes were less than 1.0 D from the intended correction after six months. The data suggest that the initial myopia affected the efficacy and predictability of the treatment; results in the mild to moderate myopia eyes were significantly better than results in the severe myopia eyes. One case of visual acuity regression (less than one line) was observed in the two groups. This was associated with corneal haze of moderate intensity.

[Treatment by refractive photokeratectomy of undercorrections after radial keratotomy]. / Traitement par photokératectomie réfractive des sous corrections après kératotomie radiaire.

UNLABELLED: Residual myopia after radial keratotomy is one of the major problems of this technique, it may be corrected with laser keratectomy. MATERIALS AND METHODS: We present the results of nine eyes treated with photorefractive keratectomy, due to undercorrection after radial keratotomy. The photoablation was performed with the laser VISX 20/20, wavelength 193 mm, and concerned a residual spherical equivalent myopia (after RK) with an average of -2.00 diopters and a range of 0.87 to -3.75 D. RESULTS: Six months postoperatively, the average spherical equivalent refraction was no greater than -0.75 D and a range of -0.25 D to -2.12 D; 66.7% were within +/- 0.5 D of emmetropia, with a uncorrected visual acuity > 10/20. The best corrected visual acuity remained nearly the same. Postoperatively functional symptomatology and healing processus are comparable to the first intention of photoablation. CONCLUSION: The safety and effectiveness of laser Excimer photoablation seem to be demonstrated and this procedure could be used to complement RK.

[Neuropapillitis in Behçet disease. A case]. / Neuropapillite de la maladie de Behçet. Une observation.

The authors report the case of a 34 year old woman, who developed acute neuropapillitis, which appeared to be the first ophthalmologic manifestation of Behçet's disease. One year later, this patient recurred with another neuro-ophthalmologic sign: a sixth nerve palsy.

[Corneal endothelium in uveitis]. / Endothélium cornéen au cours des uvéites.

The authors report the results of a prospective study concerning corneal endothelium during uveitis. They compared 65 patients (87 eyes) suffering from uveitis (divided into four groups: anterior uveitis, pars planitis, posterior uveitis, total uveitis) with a control group (36 eyes, same age). The results showed a decrease of the endothelial cell counts in the uveitis group. However this difference was not significative (Student test t). There is no difference in the endothelial cell count between each group of uveitis.