Original Article

Visual and IOP Outcomes After PRK in Pigment Dispersion Syndrome

Kraig S. Bower, MD, FACS; Rose K. Sia, MD; Denise S. Ryan, MS; Michael J. Mines, MD; Richard D. Stutzman, MD; Chrystyna P. Kuzmowych, OD; Jennifer B. Eaddy, OD; Charles D. Coe, PhD; Keith J. Wroblewski, MD

  • Journal of Refractive Surgery
  • September 2011 - Volume 27 · Issue 9: 686-690
  • DOI: 10.3928/1081597X-20110324-01
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Abstract

PURPOSE:

To report the results of photorefractive keratectomy (PRK) in patients with pigment dispersion syndrome.

METHODS:

The pre- and postoperative records of patients with pigment dispersion syndrome who underwent PRK between January 2002 and March 2009 were reviewed. Data for analysis included gender, age, ablation depth, surgical complications, manifest refraction spherical equivalent, uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), intraocular pressure (IOP), central corneal thickness (CCT), cup-to-disc (c/d) ratio, and postoperative complications.

RESULTS:

Thirty-seven eyes of 19 patients (17 men and 2 women) with a mean age of 37.5±6.9 years were included for review. At final follow-up, mean 404.1±119.5 days postoperative, UDVA was 20/15 or better in 67.6%, 20/20 or better in 91.9%, and 20/25 or better in 100% of eyes; 94.6% of eyes were within 0.50 diopters (D) and 100% were within 1.00 D of emmetropia. Corrected distance visual acuity was unchanged from preoperative in 73% and improved by one line in 27% of eyes. No eye lost 1 or more lines of CDVA. When corrected for change in CCT and curvature, mean postoperative IOP was elevated from baseline (16.7±3.8 mmHg) at 1 month (18.1±4.9 mmHg, P=.044) but unchanged at any other time postoperatively. Two (11%) of 19 patients were steroid responders, requiring a single topical agent until completing the course of steroids. No significant change was noted in mean c/d ratio from baseline (0.35±0.12) to final postoperative (0.35±0.13, P=.99).

CONCLUSIONS:

Although PRK in patients with pigment dispersion syndrome resulted in excellent UDVA, retention of CDVA, and low incidence of adverse effects 1 to 2 years after surgery, long-term safety and efficacy outcomes of PRK in this cohort remain speculative.

AUTHORS

From The Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland (Bower); and the Center for Refractive Surgery, Walter Reed Army Medical Center, Washington, DC (Sia, Ryan, Mines, Stutzman, Kuzmowych, Eaddy, Coe, Wroblewski).

The authors have no financial interest in the materials presented herein.

Portions of this material were presented as a poster at the Association for Research in Vision and Ophthalmology annual meeting, May 3–7, 2009, Ft Lauderdale, Florida; and at the American Society of Cataract and Refractive Surgery Symposium on Cataract, IOL and Refractive Surgery, April 9–14, 2010, Boston, Massachusetts.

The opinions expressed in this manuscript are those solely of the authors and do not represent the views or official policies of the United States Army or Department of Defense.

Correspondence: Kraig S. Bower, MD, FACS, The Wilmer Eye Institute, Green Spring Station, Pavilion II, Ste 455, 10793 Falls Rd, Lutherville, MD 21093. Tel: 410.847.3512; Fax: 410.847.3632; E-mail: kbower5@jhmi.edu

doi: 10.3928/1081597X-20110324-01

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