Excimer laser photorefractive keratectomy for patients with contact lens intolerance caused by dry eye

Aims/background-To evaluate epithelial wound healing and visual outcome of excimer laser photorefractive keratectomy (PRK) performed on high myopic eyes with contact lens intolerance due to dry eye. Methods-PRK was performed on two groups of patients with non-Sjogren's dry eye: group A (-6 D to -9.5 D, 11 patients, 17 eyes) and group B (-11.5 D to -19.5 D, 11 patients, 16 eyes) in an attempt to eliminate the use of contact lenses (CL). The intended correction was full in group A and 10 D in group B. Results-Uncorrected visual acuity in group A was better than 20/40 in 12 (80.0%) of 15 eyes at 6 months and in 10 (90.9%) of 11 eyes at 1 year. Fourteen (92.8%) of 17 eyes in group A and four (25.0%) of 16 eyes in group B achieved refraction within plus or minus 1 D of the intended correction at 6 months. Re-epithelialisation was complete in 4 days, and epithelial cell area and permeability returned to the preoperative level within 1 month in all cases. All patients in group A were able to eliminate CL, whereas in group B, one patient needed spectacles for residual myopia and two patients resumed CL use because of regression. One eye with severe subepithelial scar formation and one eye with macular haemorrhage were observed in group B. Conclusion-Our results suggest that PRK is effective for patients with high myopia (-6 D to approximately -10 D) and CL intolerance due to dry eye. Further studies are required to improve predictability and to prevent complications in PRK for very high myopia (> -10 D).