A Report by the American Academy of Ophthalmology

A Report by the American Academy of Ophthalmology Ophthalmic Technology Assessment Committee Refractive Surgery Panel: Christopher J. Rapuano, MD; Peter J. Agapitos, MD; William W. Culbertson, MD; Vincent P. de Luise, MD; Douglas D. Koch, MD; Alan Suger, MD

Summary

PRK is a well-accepted procedure in the United States and around the world, backed by a large volume of published research. The techniques used in the published research and described in this report are already superseded by newer techniques that require quantitative evaluation. Many of the earlier complications and poorer visual function results have been largely resolved by using a larger ablation zone, a multizone technique, and other improvements since the initial FDA trials. It appears to be a safe and effective procedure for the treatment of low to moderate degrees of myopia nd astigmatism. Results for high degrees of myopia are associated with poorer outcomes, that is, longer stabilization periods, greater need for retreatment, and increased loss of lines of BSCVA. Retreatment after PRK for low to moderate myopia appears to be safe and effective and decreases residual refractive error. However, there appear to be higher risks associated with PRK retreatment for high myopia. Because PRK is an elective procedure, it is paramount to have a thorough discussion with the patient of expectations, usual visual activities and function, and risks and benefits so that he/she is fully informed and can make an appropriate decision.