Faculty Bibliography

PURPOSE: In an investigational procedure, excimer laser photorefractive keratectomy for severe myopia was performed at three clinical trial centers to determine the effectiveness of the multiple zone technique. METHODS: A VisX Model Twenty/Twenty excimer laser (VisX, Santa Clara, California) was used to perform photorefractive keratectomy on 14 severely myopic eyes (-10.37 to -24.5 diopters) of 12 patients by using a multiple zone technique. Postoperative follow-up ranged from six months to two years; retreatments were performed on four patients, with a follow-up of at least nine months. RESULTS: At six months postoperatively, before retreatment, three of the 14 eyes were within 2 diopters and seven of the 14 eyes were within 4 diopters of attempted correction. Regression of effect to more severe myopia was worse in five eyes treated with nitrogen gas blowing. Retreatments also demonstrated considerable myopic regression. Three patients had loss of two or more lines of best-corrected visual acuity, and these patients also had moderate or severe levels of haze. CONCLUSION: Excimer laser photorefractive keratectomy for severe myopia using a multiple zone technique is associated with considerable regression, haze, and loss of best-corrected visual actuity, especially when performed in association with nitrogen gas blowing

We used a disposable bandage soft contact lens piggybacked onto a medicated, 12-hour corneal collagen shield to promote postoperative corneal epithelial healing and to provide sustained delivery of high levels of medications after corneal surgery in patients known to have poor corneal epithelial wound healing characteristics. Our experience with three patients indicates that the collagen shield dissolves completely by the first postoperative day and that the bandage lens remains in place with good mobility until it is removed when epithelialization is complete. This system eliminates the need for painful manipulation and placement of a bandage soft contact lens in an edematous, inflamed eye during the immediate postoperative period