Steep central island (SCI) formation after photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK) represents a major drawback in the visual rehabilitation of patients after refractive laser surgery. Because of the small size of SCIs, current ablation algorithms are unable to properly calculate an ablation pattern for customized retreatment. We present the use of a new ablation algorithm for the treatment of SCIs that occurred after PRK or LASIK surgery. This algorithm uses a smaller zone of approximation and takes into account the spherical shift induced by removal of the SCI. In all 3 eyes treated, best spectacle-corrected visual acuity increased to 20/16 and remained stable at the 1- and 3-month follow-up, with disappearance of the SCI in corneal topography. This new treatment algorithm may be of benefit to patients experiencing visual side effects due to SCI formation after PRK or LASIK surgery.
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