Research Article Early Refractive and Clinical Outcomes of High-Myopic Photorefractive Keratectomy as an Alternative to LASIK Surgery in Eyes with High Preoperative Percentage of Tissue Altered NirSorkin , 1,2 Amir Rosenblatt, 1 DavidSmadja, 1,3 EyalCohen , 1 MarconyR.Santhiago, 4 David Varssano , 1 and Yossi Yatziv 1 1 Department of Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel 2 Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada 3 Ophthalmology Department, Shaare Zedek Medical Center, Jerusalem, Israel 4 Department of Ophthalmology, Federal University of Rio de Janeiro, Rio De Janeiro, Brazil Correspondence should be addressed to Eyal Cohen; coheneyal123@gmail.com Nir Sorkin and Amir Rosenblatt contributed equally to this work Received 4 June 2018; Revised 21 December 2018; Accepted 3 January 2019; Published 28 January 2019 Academic Editor: Marta Sacchetti Copyright © 2019 Nir Sorkin et al. is is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Objective. To analyze the safety and efficacy of high-myopic PRK as an alternative to LASIK surgery in patients with a high preoperative percentage tissue altered (PTA). Design. Retrospective interventional case series. Participants. Charts of 256 consecutive eyes that underwent PRK with application of mitomycin-C 0.02% for high myopia were retrospectively reviewed. Methods. Refractive (refraction and refractive accuracy) and visual outcomes (uncorrected and corrected visual acuities), as well as occurrence of haze in the eyes with preoperative PTA expected to be higher than 40% with a 110-micron flap if undergoing LASIK surgery, were analyzed. Results. Mean follow-up was 7.3 ± 4.8 months. A total of 187 of 256 eyes (73.0%) were included in the analysis because they were expected to have a PTA greater than 40%, should they have undergone LASIK surgery. e actual mean PTA of those eyes following PRK was 31.8 ± 2.2%, and none had a PTA ≥ 40%. UDVA of 20/16, 20/20, and 20/25 or better was achieved in 1.2% (2 eyes), 65.5% (112 eyes), and 85.4% (146 eyes), respectively. e percentage of eyes with postoperative SE within ±0.5Dand ±1.0D of planned SE was 71% and 93%, respectively. None of the eyes lost 2 or more lines of CDVA. e rate of stromal haze, managed successfully with topical steroids only, was 4.8%. Conclusion. High-myopic PRK with application of mitomycin-C in the eyes at risk of developing ectasia because of high preoperative PTA was demonstrated to be a safe and effective alternative to the LASIK procedure. 1. Introduction Excimerlaserrefractivesurgeryinpatientswithhighmyopia is associated with an increased complication rate. Laser- assisted in situ keratomileusis (LASIK) in cases of high myopia carries an increased risk of iatrogenic ectasia [1]. Recently,thevalueofpercenttissuealtered(PTA)wasfound to be a robust indicator of the risk for post-LASIK ectasia, withPTAvaluesover40%indicatinghighectasiariskineyes with normal preoperative topography [2–4]. Abnormal preoperative topography is a risk factor of its own, regardless of the PTA value [1]. Photorefractive keratectomy (PRK) is considered safer than LASIK with regard to iatrogenic ectasia risk. However, PRK in high myopia has several drawbacks—it has been associated with lower efficacy, lower predictability [5–7], and a higher rate of stromal haze [6–8]. Increased rates of stromal haze in high-myopic PRK can be attributed to the deep stromal ablation performed [9]. Additionally, a smaller ablation diameter (which may be considered in large myopic corrections in order to conserve stromal tissue), is an independent risk factor for stromal haze [10]. Hindawi Journal of Ophthalmology Volume 2019, Article ID 6513143, 6 pages https://doi.org/10.1155/2019/6513143