To identify risk factors in a series of patients who developed steep central islands after laser in situ keratomileusis (LASIK).

METHODS

We analyzed and compared the refractive and topographic outcome of a study group composed of 83 eyes of 44 patients who underwent LASIK using the VISX Star3 excimer laser with a refraction-matched control group of 83 eyes treated later. The vacuum aspirator of the excimer laser was abnormally positioned during the surgeries performed in the study group.

RESULTS

Mean preoperative spherical equivalent refraction in the study group was -6.75 ± 2.50 D. Four eyes with a mean preoperative spherical equivalent refraction of -9.27 ± 2.29 D developed steep central islands. Thirty-three (38%) of 83 eyes treated needed retreatment for residual myopia or myopic astigmatism. In the control group, mean preoperative spherical equivalent refraction was -6.76 ± 2.50 D. Ninety-three percent of eyes were within ±1.00 D of target refraction. Five (6.02%) of 83 eyes required retreatment and no eyes developed central islands.

CONCLUSION

The abnormally positioned vacuum aspirator coupled with the higher preoperative refractive correction were the likely causative factors for central island formation and the increased incidence of undercorrection in these patients. [J Refract Surg 2003;19:309-315]

AUTHORS

From the Pepose Vision Institute, Chesterfield, MO (Cua and Pepose), and the Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, MO (Pepose).

Supported in part by the Midwest Cornea Research Foundation, Inc.

Correspondence: Jay S. Pepose, MD, PhD, Pepose Vision Institute, 16216 Baxter Rd., Ste 205, Chesterfield, MO 63017. Tel: 636.728.0111; Fax: 636.728.0093; E-mail: jpepose@peposevision.com

Received: May 20, 2002

Accepted: September 20, 2002

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