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[Excimer photorefractive keratectomy (PRK) versus intrastromal corneal ring segments (ICRS) for correction of low myopia].

PURPOSE
Theoretical differences between ablative and additive surgeries are obvious, but what about final outcome? We decide to compare surface excimer photorefractive ablation (PRK) with Intracorneal segments (Intacs or ICRS) for correction of low myopia.


MATERIAL
and


METHOD
Two homogeneous groups of 25 low pure myopic patients were considered: group A including patients operated with Excimer and group B corresponding to Intacs implanted eyes. Retrospective analysis was performed and compared data achieved at two years follow-up, in term of refractive results and qualitative vision.


RESULTS
Considering non corrected visual acuity, percentages of eyes who achieved 20/40 or better are comparable in the two series (respectively 97% in group A and 99% in group B). In the adverse, proportion of patients achieving 20/20 or more is superior in Intacs group (77%) versus 62% in PRK group. In all cases, quality of vision is altered in early postoperative period, then returns to normal between 1 and 3 months. Functional complaints appear more frequent and persisting in intrastromal segments group. Based on videotopography and cycloplegic refraction, it seems that risk of induced astigmatism occurrence is significantly increased in case of Intacs. No severe complication is mentioned in both groups.


DISCUSSION



CONCLUSION
Final outcome are in favor of the efficacy, safety and predictability of the two methods for correction of low myopia. Concept of Intacs presents the interest of potential adjustability and respect of central corneal area; however it appears to be limited by the occurrence of an induced astigmatism.