Results of Phototherapeutic Keratectomy in the Management of Flap Striae after LASIK before and after Developing a Standardized Protocol: Long-term Follow-up of an Expanded Patient Population
Received 23 March 2006; accepted 18 September 2006. published online 29 January 2007.
Objective
To evaluate the efficacy and safety of phototherapeutic keratectomy (PTK) for treatment of striae in LASIK flaps.
Design
Retrospective consecutive series.
Participants
Forty-seven eyes of 44 patients with flap striae after LASIK with reduced best-corrected visual acuity (VA) or visual symptoms with at least 3 months’ follow-up (consecutive cases from January 2001 to May 2004).
Intervention
Transepithelial PTK.
Main Outcome Measures
Uncorrected VA (UCVA), best spectacle-corrected VA (BSCVA), resolution or reduction of preoperative symptoms, and corneal haze.
Results
Mean UCVA and BSCVA improved from 20/43 and 20/29 to 20/33 and 20/23, respectively. Five eyes (10%) developed 1+ haze and 14 eyes (30%) developed trace haze, generally peaking at 1 to 2 months postoperatively. No visual symptoms or loss of acuity were attributable to haze. A mean hyperopic shift of +0.80 diopters (D) occurred after PTK treatment. Development of a standardized protocol significantly reduced the variability of the refractive shift after PTK (P = 0.003). Results were stable in up to 2 years of follow-up.
Conclusions
Phototherapeutic keratectomy treatment of LASIK flaps is well tolerated, with stable outcomes and minimal complications. A standardized treatment protocol reduced postoperative refractive variability.
1Northern California Eye Physicians Medical Group, Modesto, California.
2Department of Ophthalmology, University of California, Irvine, California.
Correspondence to Roger F. Steinert, MD, University of California, Irvine, 118 MedSurge I, Irvine, CA 92697-4375.
Manuscript no. 2006-359.
Supported in part by Research to Prevent Blindness, New York, New York (challenge grant to Department of Ophthalmology, University of California, Irvine).
The authors have no proprietary interest in any product or technique discussed in the article.
ABSTRACT