BACKGROUND: Permanent central steep islands are an undesirable phenomenon that cause distorted images and a significant reduction in visual acuity. We describe treatment of central steep islands with repeat excimer laser photoablation in the central cornea. METHODS: Three patients with preoperative refractions of -7.50 -2.50 x 170 degrees D (right eye), -8.00 -2.25 x 10 degrees D (right eye) and -6.00 -1.50 x 90 degrees (right eye) developed central steep islands which persisted more than 12 months. All patients lost more than two lines of spectacle-corrected visual acuity and complained of visual disturbances. We retreated the central steep islands with a VISX 20/20 excimer laser PRK ablation that matched the size of the central island measured on videokeratography. RESULTS: Symptomatic glare and distortion were significantly reduced and the central steep islands were resolved. Several weeks after reablation, spectacle-corrected visual acuity improved to the preoperative level. CONCLUSION: Central steep island, an infrequent complication of excimer laser photorefractive keratectomy, can be safely removed with a repeat laser ablation that matches the central circular steep area.
BACKGROUND: Permanent central steep islands are an undesirable phenomenon that cause distorted images and a significant reduction in visual acuity. We describe treatment of central steep islands with repeat excimer laser photoablation in the central cornea. METHODS: Three patients with preoperative refractions of -7.50 -2.50 x 170 degrees D (right eye), -8.00 -2.25 x 10 degrees D (right eye) and -6.00 -1.50 x 90 degrees (right eye) developed central steep islands which persisted more than 12 months. All patients lost more than two lines of spectacle-corrected visual acuity and complained of visual disturbances. We retreated the central steep islands with a VISX 20/20 excimer laser PRK ablation that matched the size of the central island measured on videokeratography. RESULTS: Symptomatic glare and distortion were significantly reduced and the central steep islands were resolved. Several weeks after reablation, spectacle-corrected visual acuity improved to the preoperative level. CONCLUSION: Central steep island, an infrequent complication of excimer laser photorefractive keratectomy, can be safely removed with a repeat laser ablation that matches the central circular steep area.