Tehran University of Medical Sciences (TUMS) Academic Journal of Surgery 2423-3218 4 1 2017 07 25 2 5 EN Hassan Hashemi Professor, Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran Mohammad Miraftab General Practitioner, Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran Soheila Asgari Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran 2017 05 16 2017 07 19 Background: The purpose of this study was to evaluate the 3-year visual outcomes in mild-to-moderate myopic patients with thin corneas who underwent photorefractive keratectomy (PRK) with or without mitomycin C (MMC). Methods: Thirty myopic eyes with a mean spherical equivalent (SE) of −3.76 ± 1.72 (−6.50 to −1.25) diopter (D) and a mean corneal thickness of 486.03 ± 11.93 (452-499) µm at the thinnest point underwent PRK. MMC was used if they had > 4.0 D myopia. All surgeries were performed with the VISX STAR S4 Excimer Laser (Abbott Medical Optics, Abbott Park, Illinois, USA). Results: Uncorrected visual acuity showed a significant improvement 3 years after surgery when compared to baseline and reached 0.01 ± 0.04 LogMAR (P < 0.001). Best-corrected visual acuity was 0.00 ± 0.01 LogMAR preoperatively and did not change significantly postoperatively. Spherical (P < 0.001) and cylindrical (P < 0.001) error significantly decreased. Manifest refraction SE showed a significant decrease when compared to before the operation and reached −0.08 ± 0.16 D (P < 0.001). At 3 years, mesopic contrast sensitivity was not significantly different from baseline at any spatial frequency. Vertical coma showed a significant decrease and reached −0.10 ± 0.27 µm (P = 0.004). Total coma (P < 0.001), spherical aberration (P < 0.001), and total high order aberrations (P < 0.001) also increased significantly. Conclusions: Based on the 3-year results, PRK (+MMC in patients with SE > 4.0 D) is a safe, effective, and predictable treatment option for mild-to-moderate myopic patients whose minimum corneal thickness is < 500 µm. https://ajs.tums.ac.ir/index.php/ajs/article/view/96 https://ajs.tums.ac.ir/index.php/ajs/article/download/96/53