title: Treatment of topographic central islands following refractive surgery.
abstract: OBJECTIVE
  To evaluate the safety and efficacy of using central reablation to treat topographic central islands following photorefractive keratectomy (PRK), myopic keratomileusis in situ, and laser in situ keratomileusis (LASIK).
  
  
  METHODS
  Department of Ophthalmology, Stanford University School of Medicine, Stanford, and Jules Stein Eye Institute, Los Angeles, California, USA.
  
  
  METHODS
  Central reablation was performed on eight eyes with clinically significant topographic central islands after refractive surgery. Two eyes developed central islands after PRK, five eyes after LASIK, and one eye after myopic keratomileusis in situ. A clinically significant topographic central island was defined as an area of steepening of at least 3.0 diopters by at least 1.5 mm in diameter documented by computerized videokeratography. Reablation was tailored to each eye based on the diameter and power of the topographic central island using the Munnerlyn formula.
  
  
  RESULTS
  All eyes experienced a reduction or elimination of the topographic central islands following central reablation. Six eyes experienced an improvement in uncorrected visual acuity, and all eyes returned to within one line of their preoperative level of best spectacle-corrected visual acuity 1 month after the procedure.
  
  
  CONCLUSIONS
  Topographic central islands following PRK, myopic keratomileusis in situ, and LASIK can be effectively treated using the excimer laser. Poor predictability of the refractive effect of central reablation may be the limitation of this treatment modality.
authors.affiliation: Stanford University School of Medicine, Department of Ophthalmology, California 94305-5308, USA.
authors.forename: E E
authors.initials: EE
authors.lastname: Manche
authors.forename: R K
authors.initials: RK
authors.lastname: Maloney
authors.forename: R J
authors.initials: RJ
authors.lastname: Smith
mesh_terms: D000328:Adult; D003315:Cornea / Q000601:surgery*; D019781:Corneal Topography; D016039:Corneal Transplantation / Q000009:adverse effects / Q000379:methods; D006801:Humans; D053685:Laser Therapy; D054018:Lasers, Excimer; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000601:surgery*; D018903:Photorefractive Keratectomy / Q000009:adverse effects; D011183:Postoperative Complications / Q000601:surgery*; D012086:Reoperation; D012449:Safety; D016896:Treatment Outcome; D014792:Visual Acuity