PHOTOREFRACTIVE KERATECTOMY IN AFRICAN-AMERICANS INCLUDING THOSE WITHKNOWN DERMATOLOGICAL KELOID FORMATION

PURPOSE: To report the outcome of photorefractive keratectomy in Afric an Americans, including those with a known history of dermatologic kel oid formation. METHODS: A retrospective analysis of African American p atients who had photorefractive keratectomy at either of our instituti ons was undertaken to identify all patients who were at least 3 months status post refractive surgery. The presence or absence of a history of keloid formation, as well as preoperative and postoperative measure ments of uncorrected visual acuity, best-corrected visual acuity, mani fest refraction, and the presence and magnitude of any postoperative c orneal haze were analyzed. RESULTS: Twelve patients (19 eyes) met the in elusion criteria and three of these patients (six eyes) had a histo ry of keloid formation. Mean uncorrected visual acuity a SD for the en tire study group improved from 20/369 +/- 20/270 preoperatively to 20/ 19.4 +/- 20/7.1 postoperatively (average follow-up, 13.8 months). All eyes had postoperative uncorrected visual acuity of 20/40 or better; 1 4 (74%) achieved 20/20 or better. Mean best spectacle corrected visual acuity went from 20/14.8 +/- 20/2.8 preoperatively to 20/15.5 +/- 20/ 3.2 postoperatively (not statistically significant). Mean manifest sph erical equivalent was -4.9 +/- 3.4 diopters preoperatively and +0.03 /- 0.55 diopters postoperatively. Eight eyes (42%) had trace to 1+ cor neal haze following photorefractive surgery. A comparison of postopera tive uncorrected and best corrected visual acuities of known keloid fo rmers with nonkeloid formers revealed no significant statistical diffe rence. CONCLUSIONS: African Americans may have excellent visual outcom es following photorefractive keratectomy. History of keloid formation does not appear to have an adverse effect on the outcome. These result s question whether known dermatologic keloid formation should be contr aindication to photorefractive keratectomy. (Am J Ophthalmol 1998;126: 625-629, (C) 1998 by Elsevier Science Inc. All rights reserved.).