Enhancement outcomes after photorefractive keratectomy and laser in situ keratomileusis using topographically guided excimer laser photoablation.

PURPOSE To evaluate the efficacy and safety of topographically guided excimer laser photoablation to retreat unsuccessful myopic and hyperopic photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK). SETTING Eye Clinic, San Salvatore Hospital, University of L'Aquila, L'Aquila, Italy. METHODS At least 3 months after primary PRK (Group A) or primary LASIK (Group B), 48 eyes of 42 patients were submitted to PRK or LASIK enhancements. The eyes were treated with an excimer laser linked to a computerized videokeratography unit with a topographically supported customized ablation workstation. RESULTS The mean follow-up was 27.8 months +/- 8.2 (SD). In Group A, the uncorrected visual acuity (UCVA) changed from 0.5 +/- 0.7 logarithm of the minimum angle of resolution (logMAR) (range 20/600 to 20/200) to 0.1 +/- 0.7 logMAR (range 20/60 to 20/20); the mean best spectacle-corrected visual acuity (BSCVA) changed from 0.1 +/- 0.7 logMAR (range 20/50 to 20/20) to 0 +/- 0.7 logMAR (range 20/50 to 20/20) after the enhancement. In Group B, the UCVA changed from 0.7 +/- 0.8 logMAR (range 20/600 to 20/40) to 0.1 +/- 0.7 logMAR (range 20/40 to 20/20); the mean BSCVA improved from 0.2 +/- 0.8 logMAR (range 20/30 to 20/20) to 0 +/- 1.3 logMAR (range 20/25 to 20/20) after surgery. CONCLUSIONS The enhancements using topographically guided excimer laser photoablation with a topographically supported customized ablation method resulted in satisfactory and stable visual outcome with good safety and efficacy after unsuccessful PRK and LASIK.