Combined laser in situ keratomileusis and photorefractive keratectomy for extreme myopia.

BACKGROUND: Current refractive surgical techniques, specifically photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK) for the correction of extreme myopia (more than -20.00 diopters) are unpredictable and undercorrections occur frequently. A combination of both techniques, used simultaneously or separately, expands their individual range, and allows correction of higher amounts of myopia. METHODS: Both eyes of a 24-year old female patient who had a spherical equivalent refraction of -37.00 -2.00 x 170 degrees in her right eye and -38.00 -2.00 x 180 degrees in her left eye underwent LASIK and PRK (transepithelial) at the same sitting, using the Chiron automated corneal shaper and the Chiron Technolas Keracor 116 excimer laser. RESULTS: One month postoperatively, she had an uncorrected visual acuity of 20/100 in her right eye with a spherical equivalent refraction of +3.00 sphere and 20/200 in her left eye. One year after surgery she had an uncorrected visual acuity of 20/70 and a spherical equivalent refraction of +1.00 -1.00 x 30 degrees in her right eye and in her left eye 20/80 with a refraction of +1.25 sphere. CONCLUSION: LASIK and PRK combined in a simultaneous procedure are an alternative for the surgical management of extreme myopia.