Effect of photorefractive keratectomy on optic nerve head topography and retinal nerve fiber layer thickness measured by heidelberg retina tomograph 3

Abstract

Purpose: To determine whether photorefractive keratectomy (PRK) has a significant effect on optic nerve head (ONH) parameters and peripapillary retinal nerve fiber layer (RNFL) thickness measured by the Heidelberg Retina Tomograph 3 (Heidelberg Engineering GmbH, Heidelberg, Germany) in eyes with low to moderate myopia. Methods: This prospective, interventional case series, includes 43 consecutive myopic eyes which were assessed on the day of PRK and 3 months postoperatively using the HRT3. Among the stereometric parameters, we compared disc area, linear cup disc ratio, cup shape measure, global rim area, global rim volume, RNFL height variation contour and mean RNFL thickness; out of the Glaucoma Probability Score (GPS) we assessed changes in global value, rim steepness temporal/superior, and temporal/inferior, as well as cup size and cup depth before and after PRK. Results: Mean refractive error before and after PRK were −3.24 ± 1.31 and −0.20 ± 0.42 diopters, respectively. No significant change occurred in disc area, linear cup disc ratio, cup shape measure, rim area and rim volume among the stereometric parameters; and in rim steepness temporal/superior and rim steepness temporal/inferior in the GPS before and after PRK using the default average keratometry. However, RNFL height variation contour, mean RNFL thickness, and cup size and depth were significantly altered after PRK (P < 0.05). Conclusion: PRK can affect some HRT3 parameters. Although the most important stereometric parameters for differentiating normal, suspect or glaucomatous patients such as rim and cup measurements in stereometric parameters were not changed.

Keywords

• Glaucoma; Heidelberg Retina Tomograph; Myopia; Photorefractive Keratectomy