Corneal topography of small-beam tracking excimer laser photorefractive keratectomy

Purpose: To evaluate the topographic characteristics of photorefractive keratectomy (PRK) for low myopia performed with a small-beam (0.9 mm) tracking excimer laser. Setting: Department of Ophthalmology, LSU Eye Center, Louisiana State University Medical Center School of Medicine in New Orleans, and the Refractive Surgery Center of the South at the Eye, Ear, Nose, & Throat Hospital, New Orleans, Louisiana, USA. Methods: Sixty-seven eyes of 47 patients had PRK with a small-beam tracking laser. Of these, 49 eyes had data permitting evaluation of ablation centration; usable data for topographic analysis were available for 59 eyes preoperatively, 54 eyes at 1 month, 42 eyes at 3 months, and 25 eyes at 6 months, permitting measurement of various topographic parameters, including the cylinder (CYL), average corneal power (ACP), surface regularity index (SRI), surface asymmetry index (SAI), corneal eccentricity index (CEI), and coefficient of variation of corneal power (CVP). Results: Preoperatively, all eyes were topographically normal. Postoperatively, no eye exhibited a "central island" by even the least-restrictive definition, and all eyes had best spectacle-corrected visual acuities (BSCVAs) of 20/20 or better at all follow-ups. Mean decentration of the ablations from the pupil centers was 0.42 mm +/- 0.28 (SD) (n = 49). There was no correlation between measured decentration and BSCVA (P =.46). The central cornea was flattened (decreased ACP; P <.001) and made oblate (decreased CEI; P <.001) as expected. There was no increase in SRI or SAI (irregular astigmatism) at 6 months compared with preoperative values (P =.91); however, CYL and CVP (varifocality) increased slightly (P =.04 and .02, respectively). Conclusion: The absence of significant regular or irregular astigmatism 6 months after PRK with the small-beam laser is an improvement over published results achieved with wide-beam lasers and is consistent with the excellent visual acuity results in this cohort. J Cataract Refract Surg 1999; 25:675-684 (C) 1999 ASCRS and ESCRS.