Central bump-like opacity as a complication of high hyperopic photorefractive keratectomy

PURPOSE: A new complication is reported in association with high hyperopic excimer laser photorefractive keratectomy. METHODS: One thousand consecutive eyes were treated with a Meditec MEL-60 e xcimer laser (Meditec Inc, Heroldsberg, Germany) for hyperopic refractive e rror between fl diopters and +7 diopters, RESULTS: Three eyes with high hyperopic corrections between +5 and +6 diopt ers had a central, round bump-like subepithelial scar develop 1 month after hyperopic photorefractive keratectomy, which reduced the uncorrected and s pectacle-corrected visual acuity. CONCLUSION: Central bump-like opacity is a neu, visually significant compli cation of unknown origin associated with high hyperopic photorefractive ker atectomy. Possible causes of this complication include drying and edema of the cornea as a result of prolonged exposure, interruption of the periphera l superficial nerve plexus affecting the central anterior stroma, and abnor mal epithelial or tear film function resulting from excessive central steep ing. (C) 1999 by Elsevier Science Inc. All rights reserved.