Programm                 "Degeneration und Regeneration– Grundlagen, Diagnostik und Therapie"

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Assessment of a Two-Step Procedure for High Myopia Correction

Berret R., Vega W., Bende T., Jean B.
University Eye Hospital Tübingen, Div. I, Department Experimental Ophthalmic Surgery

Purpose: Limitation of PRK/LASEK for myopia correction formerly has been agreed to be in the order of -6.0 D. Corrections over -6.0 D were known to show higher incidence of corneal haze and reduced predictability. To reduce corneal haze and to achieve higher accuracy, the amount of ametropia was split in two procedures.
Method: Patients with a preoperative spherical equivalent between -8.0 and -16.0 D were corrected for emetropia with a first baseline correction of -5.0 to -8.0 D and a second correction performed at least six months apart aiming to correct the residual ametropia. For both steps the either the Summit Apex Plus (Summit Technologies, USA, no eyetracker) or the SCHWIND Keratom MultiScan (Schwind EyeTech, Germany, with eyetracker) were used. The functional and optical results are compared with nowadays single-step corrections for higher degrees of myopia.
Results: Compared to high myopia PRK/LASEK corrections being performed in one step no advantage could be found. Neither corneal haze nor accuracy were decreased. For the second step an increased risk of decentration, especially for the Summit Apex Plus, was found. Best Spectacle Corrected Visual Acuity (BSCVA) postoperatively remained mainly unchanged. Finally no eye lost more than one line of BSCVA.
Conclusions: Today we perform PRK/LASEK corrections of high myopia if possible in a singl

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