Phototherapeutic keratectomy for decentration and central islands after photorefractive keratectomy

Purpose: To determine visual outcomes after treatment of decentration and c entral islands occurring after photorefractive keratectomy (PRK), Design: Retrospective, noncomparative case series. Participants: Patients In = 14) who exhibited decentration or central islan ds after PRK and photoastigmatic keratectomy (PARK). Methods: Fourteen eyes with post-PRK decentration (group I) or central isla nds (group II) were treated by transepithelial phototherapeutic keratectomy guided by epithelial fluorescence without modulating agents, and subsequen tly were treated with PRK or PARK. Mean follow-up time was 9 months (range, 45 days-21 months). Main Outcome Measures: We analyzed pre- and postoperative keratometry, refr active errors, uncorrected visual acuity (UCVA), best-corrected visual acui ty, and haze. In group I, we also measured pre- and postoperative decentrat ion; in group II, we compared pre- and postoperative central island power. Results: Group I showed improvement in centration (P = 0.003), Group II sho wed decreased central island power (P = 0.18), -LogMAR UCVA improved from 0 .59 (20/80(+1)) to 0.17 (20/30) IP = 0.03) and from 0.74 (20/100(-1)) to 0. 21 (20/30(-1)) (P = 0.01) after retreatment of groups I and II, respectivel y. Conclusions: Retreatment of patients having decentration and central island s after PRK results in improved visual outcomes. (C) 2001 by the American A cademy of Ophthalmology.