Results of phototherapeutic keratectomy in the management of flap striae after LASIK

Abstract

Objective To evaluate the efficacy of phototherapeutic keratectomy (PTK) in reducing or resolving visually significant surface irregularities resulting from flap striae after LASIK. Design Retrospective, noncomparative case series. Participants Twenty-three eyes of 22 patients with flap striae after LASIK and reduced best-corrected visual acuity or visual symptoms that resolved with diagnostic contact lens fitting treated between January 2001 and April 2002 with at least 1 month of follow-up. The mean follow-up interval was 134 days (range, 30–354 days). Intervention Transepithelial PTK. Main outcome measures Uncorrected visual acuity (UCVA), resolution or reduction of preoperative symptoms, corneal haze, and best spectacle-corrected visual acuity (BSCVA). Results Mean BSCVA and UCVA improved significantly from 20/32 and 20/48 to 20/22 and 20/33 ( P<0.0001 and P = 0.027), respectively, after PTK. There was a significant mean hyperopic shift of 0.88 diopters (D; P = 0.002, range, −1.38 to +3.88 D). Fourteen eyes (61%) were clinically clear, 6 eyes (23%) had trace haze, and 3 eyes (16%) had 1+ haze at the last follow-up visit. Mean spherical equivalent refractive error before LASIK was −7.23 D (range, −2.88 to −13.55 D). Twenty-two of 23 eyes had significant qualitative resolution or reduction of preoperative visual symptoms. Conclusions In cases of visually significant LASIK flap striae, PTK is effective in improving best-corrected visual acuity and reducing visual symptoms. High myopia may be a risk factor for development of visually significant microstriae. Development of anterior stromal haze did not exceed 1+ density and was not correlated to either the number of laser pulses or the length of the follow-up period.