Photorefractive keratectomy Delivers Excellent Vision Outcomes in Myopia: Study
Medical Lapse at Thiruvananthapuram Eye Hospital
A prospective study published in the Indian Journal of Ophthalmology found that photorefractive keratectomy (PRK) is a safe and effective refractive surgery option for correcting low, moderate, and high myopia. At 12 months after surgery, 92.3% of patients with low-to-moderate myopia and 88.5% of those with high myopia achieved 6/6 uncorrected distance visual acuity (UDVA), indicating excellent visual recovery without glasses. The procedure significantly improved vision across all myopia groups, with minimal complications and no need for enhancement surgery, supporting PRK as a reliable alternative for patients who may not be suitable candidates for LASIK.
While laser-assisted in situ keratomileusis (LASIK) remains popular, PRK strategically eliminates flap-related complications and preserves more underlying stromal bed tissue, prompting researchers Dr. Surabhi R. Kumar and colleagues from the Government Medical College and Hospital in Nagpur to prospectively evaluate its precise visual efficacy and complication rates across varying degrees of nearsightedness to bridge a critical clinical gap in resource-limited tertiary care environments.
Therefore, the prospective study evaluated 78 myopic eyes (52 low-to-moderate, 26 high) at a central Indian tertiary center. Following strict clinical exclusions, the primary endpoint assessed was postoperative uncorrected distance visual acuity (UDVA), alongside secondary clinical outcomes including corrected vision (CDVA), refractive stability (MRSE), and surgical complications.
Key Clinical Findings of the Study Includes:
Exceptional Visual Recovery: Investigators revealed that 92.31% of the low-to-moderate myopia group and 88.5% of the high myopia cohort attained an impressive 6/6 UDVA at the twelve-month evaluation point.
Excellent Refractive Stability: Researchers found the mean MRSE stabilized effectively by one year, recording minimal residual refractive errors of -0.15D, -0.26D, and -0.21D in low, moderate, and high myopic eyes, respectively.
Transient Corneal Haze: Clinicians observed a mild degree of corneal haze in approximately 30% of high myopic eyes initially, which resolved entirely and spontaneously without any late-onset keratitis or persistent stromal opacification by the end of the year.
Predictable Pain Trajectory: Analysts noted that while subjective pain scores peaked twenty-four hours post-surgery, these symptoms rapidly subsided, leading to complete epithelial healing by day seven and zero pain reported by the first month.
The results suggest that PRK is an exceptionally predictive, stable, and safe surface ablation modality, successfully yielding 6/6 or better uncorrected visual acuity for over 88% of patients across the myopic spectrum over a 12-month period without the need for subsequent enhancement surgeries.
Thus, the study concludes practitioners might consider this surface treatment as a highly viable and reliable alternative for individuals desiring surgical refractive correction but possessing anatomical or clinical contraindications for lamellar flap procedures like LASIK or the intraocular implantation of phakic lenses.
While these observed clinical findings are highly encouraging, the relatively small sample size and limited one-year follow-up period gently indicate that subsequent evaluations involving larger participant pools over extended durations would be beneficial to further confirm late-term refractive stability and robustly assess qualitative visual metrics such as contrast sensitivity and higher-order aberrations.
Reference
Kumar SR, Dhabarde K, Joshi RS. The outcome of photorefractive keratectomy in low, moderate, and high myopia: A prospective observational study in a tertiary care center of Central India. Indian J Ophthalmol 2026;74:48-52.
