| Natural history of central topographic islands following excimer laser photorefractive keratectomy. | |
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MedLine Citation:
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PMID: 8972365 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: To assess the incidence and natural history of central corneal topographic islands following excimer laser photorefractive keratectomy (PRK) and photoastigmatic refractive keratectomy (PARK). SETTING: A dedicated corneal diseases and refractive surgery unit within a National Health Service Trust ophthalmology unit in the United Kingdom. METHODS: Corneal topographic analysis was performed in a prospective study of 100 eyes of 75 consecutive patients who had PRK. All PRK/PARK excimer laser photorefractive procedures were performed by two surgeons observing a standardized protocol using a VISX 20/20 excimer laser. Mean preoperative myopic error was 5.54 diopters (D) +/- 3.44 (SD). Corneal topographic analysis was performed on all eyes preoperatively, 1 week postoperatively, and monthly thereafter for a minimum of 6 months or until central islands, if present, resolved. All patients had a minimum 12 months follow-up. RESULTS: Postoperatively, 29 eyes (29%) demonstrated central corneal topographic islands of greater than 3.00 D topographic power by computerized videokeratography (CVK). All central islands were identified in the first 4 weeks postoperatively. In all cases the differential dioptric power, created by the central islands within the ablation zone, decreased rapidly; within 6 months, 26 (90%) central islands had fully resolved without further treatment, and the remaining 3 (10%) resolved within 1 year of photorefractive surgery. The occurrence of central islands was related to higher preoperative myopic spherical equivalent (P = .01), greater attempted laser correction (P = .01), and greater projected depth of ablation (P = .01) (Student's two-tailed t-test). CONCLUSIONS: Central corneal topographic islands occurred in a significantly higher proportion of eyes having excimer laser photorefractive surgery than previously believed. The islands were associated with decreased unaided vision, reduced best spectacle-corrected acuity, and other troublesome visual symptoms; however, the central islands, along with their associated visual effects, usually resolved without surgical intervention within 6 months postoperatively. |
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Authors:
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C N McGhee; I G Bryce |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of cataract and refractive surgery Volume: 22 ISSN: 0886-3350 ISO Abbreviation: J Cataract Refract Surg Publication Date: 1996 Nov |
Date Detail:
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Created Date: 1997-02-26 Completed Date: 1997-02-26 Revised Date: 2008-11-21 |
Medline Journal Info:
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Nlm Unique ID: 8604171 Medline TA: J Cataract Refract Surg Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1151-8 Citation Subset: IM |
Affiliation:
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Corneal Diseases and Excimer Laser Unit, Sunderland Eye Infirmary, United Kingdom. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Astigmatism / surgery* Cornea / pathology*, surgery Corneal Diseases / etiology*, pathology Female Humans Image Processing, Computer-Assisted Lasers, Excimer Male Middle Aged Myopia / surgery* Photorefractive Keratectomy / adverse effects* Postoperative Complications / etiology, pathology Prospective Studies |
| Comments/Corrections | |
Comment In:
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J Cataract Refract Surg. 1999 Mar;25(3):302-4
[PMID:
10079427
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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