title: Results of phototherapeutic keratectomy in the management of flap striae after LASIK before and after developing a standardized protocol: long-term follow-up of an expanded patient population.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of phototherapeutic keratectomy (PTK) for treatment of striae in LASIK flaps.
  
  
  METHODS
  Retrospective consecutive series.
  
  
  METHODS
  Forty-seven eyes of 44 patients with flap striae after LASIK with reduced best-corrected visual acuity (VA) or visual symptoms with at least 3 months' follow-up (consecutive cases from January 2001 to May 2004).
  
  
  METHODS
  Transepithelial PTK.
  
  
  METHODS
  Uncorrected VA (UCVA), best spectacle-corrected VA (BSCVA), resolution or reduction of preoperative symptoms, and corneal haze.
  
  
  RESULTS
  Mean UCVA and BSCVA improved from 20/43 and 20/29 to 20/33 and 20/23, respectively. Five eyes (10%) developed 1+ haze and 14 eyes (30%) developed trace haze, generally peaking at 1 to 2 months postoperatively. No visual symptoms or loss of acuity were attributable to haze. A mean hyperopic shift of +0.80 diopters (D) occurred after PTK treatment. Development of a standardized protocol significantly reduced the variability of the refractive shift after PTK (P = 0.003). Results were stable in up to 2 years of follow-up.
  
  
  CONCLUSIONS
  Phototherapeutic keratectomy treatment of LASIK flaps is well tolerated, with stable outcomes and minimal complications. A standardized treatment protocol reduced postoperative refractive variability.
authors.affiliation: Northern California Eye Physicians Medical Group, Modesto, California, USA.
authors.forename: Amin
authors.initials: A
authors.lastname: Ashrafzadeh
authors.forename: Roger F
authors.initials: RF
authors.lastname: Steinert
mesh_terms: D000328:Adult; D002985:Clinical Protocols / Q000592:standards; D003316:Corneal Diseases / Q000209:etiology / Q000601:surgery*; D003319:Corneal Stroma / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D019466:Glare; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects*; D054018:Lasers, Excimer; D008297:Male; D008875:Middle Aged; D018903:Photorefractive Keratectomy / Q000379:methods*; D012086:Reoperation; D013524:Surgical Flaps; D016896:Treatment Outcome; D014792:Visual Acuity