Effect of Belin-Ambrósio deviation index on 2-year refractive outcomes of PRK

J Cataract Refract Surg. 2024 Nov 1;50(11):1143-1150. doi: 10.1097/j.jcrs.0000000000001521.

Abstract

Purpose: To assess the effect of preoperative Belin-Ambrósio deviation (BAD-D) index on 2-year visual, refractive, and tomographic outcomes, as well as the efficacy and safety of photorefractive keratectomy (PRK) surgery.

Setting: Eye clinic, Mashhad, Iran.

Design: Prospective cohort study.

Methods: This study included 66 patients (66 eyes) who underwent PRK surgery, with a minimum follow-up period of 2 years. Participants were divided into 2 groups: preoperative BAD-D ≥1.60 (high BAD-D) and preoperative BAD-D <1.60 (low BAD-D). Preoperative and postoperative visual, refractive, and tomographic parameters were evaluated, and the efficacy and safety of the procedure were compared between groups.

Results: 66 patients with a mean age of 35.50 ± 8.21 years (range 22 to 55 years) were included. Postoperatively, the mean spherical equivalent (SE) of refractive error was +0.32 ± 0.65 diopters (D) in the high BAD-D group and +0.18 ± 0.66 D in the low BAD-D group ( P = .40). In addition, at 2 years of follow-up, the mean uncorrected distance visual acuity was 0.98 ± 0.07 in the high BAD-D group and 0.97 ± 0.08 in the low BAD-D group ( P = .905). Among the postoperative tomographic parameters, front elevation thickness, maximum Ambrósio relational thickness, astigmatism, and central corneal thickness were significantly different between the 2 groups (all, P < .05). At the 2-year follow-up, the mean Safety Index was 1.02 ± 0.04, and 1.01 ± 0.04 in high and low BAD-D groups, respectively ( P = .37), and the mean Efficacy Index was 0.99 ± 0.07 and 0.98 ± 0.06 in high and low BAD-D groups, respectively ( P = .40).

Conclusions: The preoperative BAD-D index does not predict postoperative visual, refractive, and tomographic outcomes in patients with low-to-moderate myopia. However, in patients with normal preoperative BAD-D values, higher agreement was expected between the attempted and achieved SE.

MeSH terms

  • Adult
  • Cornea / pathology
  • Cornea / physiopathology
  • Cornea / surgery
  • Corneal Topography
  • Female
  • Follow-Up Studies
  • Humans
  • Lasers, Excimer* / therapeutic use
  • Male
  • Middle Aged
  • Myopia* / physiopathology
  • Myopia* / surgery
  • Photorefractive Keratectomy* / methods
  • Prospective Studies
  • Refraction, Ocular* / physiology
  • Treatment Outcome
  • Visual Acuity* / physiology
  • Young Adult