Influence of excimer laser photorefractive keratectomy on the posterior corneal surface

PURPOSE: To investigate the influence of excimer laser photorefractive keratectomy on the refraction and geometry of the posterior corneal surface. SETTING: Miyata Eye Hospital, Miyazaki, Japan. METHODS: Thirty-seven eyes of 21 patients with refractive errors of -2.00 to -9.75 diopters (D) were treated with the VISX Twenty-Twenty excimer laser system. The refractive and anteroposterior changes in the posterior corneal surface were measured using scanning-slit corneal topography (Orbscan, Orbtek, Inc.) preoperatively and 1 week and 1 and 3 months postoperatively. RESULTS: Mean posterior corneal refraction was -6.51 D +/- 0. 29 (SD) preoperatively; it decreased to -7.00 +/- 0.49 D, -7.00 +/- 0.55 D, and -6.92 +/- 0.42 D at 1 week, 1 month, and 3 months, respectively (P <.001, Tukey multiple comparison). Mean forward shift of the posterior corneal surface was 29.5 +/- 1.9 microm, 34.4 +/- 3.4 microm, and 54.3 +/- 4.0 microm at 1 week, 1 month, and 3 months, respectively. The amount of posterior corneal refractive change correlated with the degree of forward shift (r= -0.691, P <. 001). The residual corneal thickness correlated with the refractive change (r = 0.524, P <.001) and the forward shift (r = -0.851, P <. 001) of the posterior corneal surface. CONCLUSION: Photorefractive keratectomy induced significant refractive changes in the posterior corneal surface and forward shift of the cornea, both of which correlated with the thinness of the residual cornea.