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Introduction & Objective: This study was performed to compare the visual and refractive outcomes of photorefractive keratectomy (PRK) in eyes with medium-high astigmatism by WF-guided method using Visx system and cross-cylinder method using Nidek EC-5000 excimer laser system. Although there are many studies about efficacy and safety of Wave front guided and Cross Cylinder Photorefractive Keratectomy, there are few studies on moderate to high astigmatism. Materials & Methods: In a descriptive comparative study, WF-PRK was performed on 50 eyes of 25 patients with compound myopic astigmatism. Each patient underwent PRK by WF-guided approach. Then the results were compared with the cross-cylinder PRK previously performed on 48 eyes of 24 patients . Results: After 6 months, 100% of the eyes in the WF group had uncorrected visual acuity of 20/25 or better compared to 79.2% in the cross-cylinder group . Mean refractive astigmatism had decreased by 1.57± 0.53 in the WF group and 1.670.52 in the cross-cylinder group (P=0.75). Mean postoperative absolute change in total root-mean-square higher order aberrations in the WF group and cross-cylinder group were 0.05 0.22 µm and 0.170.20µm, respectively (P

OBJETIVO: Comparar os resultados obtidos pelas técnicas de "laser in situ keratomileusis" (LASIK) e "photorefractive keratectomy" (PRK) na correção de miopia e astigmatismo em olhos previamente submetidos à cirurgia de descolamento de retina (DR) com "buckle" escleral. MÉTODOS: Vinte e cinco olhos de 22 pacientes com alterações refracionais significativas após a cirurgia de DR foram submetidos à cirurgia refrativa. Em 14 olhos de 13 pacientes foi realizado LASIK e em 11 olhos de 9 pacientes, PRK. O intervalo mínimo entre a cirurgia de DR e a cirurgia refrativa foi de 12 meses. O tempo de seguimento foi de, pelo menos, 12 meses. RESULTADOS: Doze meses após a cirurgia, a média do equivalente esférico (EE) no grupo submetido ao LASIK diminuiu de -6,49 D antes da cirurgia para -0,17 D e a média do cilindro de -1,10 D para -0,23 D. A média do EE no grupo submetido ao PRK foi reduzida de -5,35 D para +0,02 D e a média do cilindro, de -1,38 D para -0,54D. Em ambos os grupos, 11 olhos apresentaram melhora da acuidade visual sem correção de pelo menos 4 linhas. CONCLUSÃO: Tanto o LASIK quanto o PRK foram seguros e eficazes para a correção do erro refracional induzido após a cirurgia de DR. Nossos resultados não apresentaram diferenças significativas entre os procedimentos. Estudos posteriores envolvendo maior amostragem e seguimento mais prolongado contribuirão para melhor avaliação da cirurgia refrativa em pacientes submetidos à cirurgia com "buckle" escleral. PURPOSE: To compare the results of "laser in situ keratomileusis" (LASIK) and "photorefractive keratectomy" (PRK) to correct myopia and astigmatism in eyes previously submitted to retinal detachment (RD) surgery with scleral "buckle". METHODS: Twenty-five eyes of 22 patients submitted to scleral buckling procedure with significant refraction changes after surgery were evaluated. Fourteen eyes of 13 patients underwent LASIK and 11 eyes of 9 patients underwent PRK. Minimum time between RD surgery and refractive surgery was 12 months. All patients were followed-up for at least 12 months. RESULTS: Twelve months after surgery, mean spherical equivalent in the LASIK group changed from -6.49D preoperatively to -0.17D and mean astigmatism decreased from -1.10D to -0.23D. Spherical equivalent in the PRK group decreased from -5.35D before surgery to +0,02D and average astigmatism changed from -1.38D to -0.54D. In both groups, uncorrected visual acuity (UCVA) improved at least 4 lines in 11 eyes. CONCLUSION: Both LASIK and PRK were safe and effective to correct refractive error after RD surgery. Our results showed no significant difference between procedures. Further studies with more patients and long-term follow-up are required to better evaluate the effects of refractive surgery in patients submitted to scleral buckling procedure.