Phototherapeutic keratectomy for decentration and central islands after photorefractive keratectomy

Purpose: To determine visual outcomes after treatment of decentration and central islands occurring after photorefractive keratectomy (PRK). Design: Retrospective, noncomparative case series. Participants: Patients (n = 14) who exhibited decentration or central islands after PRK and photoastigmatic keratectomy (PARK). Methods: Fourteen eyes with post-PRK decentration (group I) or central islands (group II) were treated by transepithelial phototherapeutic keratectomy guided by epithelial fluorescence without modulating agents, and subsequently 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, refractive errors, uncorrected visual acuity (UCVA), best-corrected visual acuity, and haze. In group I, we also measured pre- and postoperative decentration; in group II, we compared pre- and postoperative central island power. Results: Group I showed improvement in centration (P = 0.003). Group II showed decreased central island power (P = 0.18). - LogMAR UCVA improved from 0.59 (20/80⁺¹) to 0.17 (20/30) (P = 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, respectively. Conclusions: Retreatment of patients having decentration and central islands after PRK results in improved visual outcomes.