Central Islands and Visual Outcomes of Phototherapeutic Keratectomy Using the Photorefractive Keratectomy Mode. Issue 1 (January 2019)

• Record Type: Journal Article
• Authors: Kamiya, Kazutaka; Takahashi, Masahide; Igarashi, Akihito; Shoji, Nobuyuki
• Is Part Of: Cornea. Volume 38:Issue 1(2019)
• Publication Date: 2019-01
• Subjects: central island -- visual acuity -- PTK -- band keratopathy -- granular corneal dystrophy; Cornea -- Periodicals; Cornea -- Periodicals; Cornée -- Périodiques; 617.719
• DOI: 10.1097/ICO.0000000000001761
• Languages: English
• ISSNs: 0277-3740

Abstract

Abstract : Purpose: To compare the rate of central island (CI) and visual acuity after phototherapeutic keratectomy (PTK) with and without the CI program. Methods: This retrospective study comprised 147 eyes of 89 consecutive patients (mean age ± SD, 71.1 ± 9.6 years) undergoing PTK with and without the anti-CI program [photorefractive keratectomy (PRK) mode and PTK mode] using the VISX Star S4 excimer laser system (Johnson & Johnson Vision, Santa Ana, US) for treatment of band keratopathy (BK) or granular corneal dystrophy (GCD). The rate of CI formation, defined as a steepening area of 3 D, 1.5 mm in diameter, on each corneal videokeratographer (ATLAS 9000; Carl Zeiss Meditec, Jena), and best spectacle-corrected visual acuity (BSCVA) were assessed 3 months after PTK. Results: We found CI formation in 17 eyes (22%) in the PRK mode group and 45 eyes (73%) in the PTK mode group at 3 months postoperatively ( P < 0.001, χ 2 test). Postoperative logarithm of the minimal angle of resolution BSCVA was 0.10 ± 0.14 in the PRK group and 0.15 ± 0.13 in the PTK group ( P = 0.019, Student t test). The rate of CI was 13 eyes (33%) with BK and 6 eyes (15%) with GCD in the PRK mode group and 25 eyes (83%) with BK and 20 eyes (71%) with GCD in the PTK mode group. Conclusions: The use of the anti-CI program for PTK significantly decreases the rate of CI formation and significantly improves BSCVA in post-PTK eyes, suggesting its viability for treatment of BK and GCD in clinical setting.