Lee J S, Joo C K
Department of Ophthalmology, Kangnam St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul.
Korean J Ophthalmol. 2001 Jun;15(1):8-14. doi: 10.3341/kjo.2001.15.1.8.
A central island is defined as a localized elevated area in corneal topography after excimer laser application for myopic correction. We experienced 15 cases of central islands developed 1 week after LASIK using VISX STAR on corneal topography. The uncorrected visual acuity and best corrected visual acuity were 0.52 +/- 0.22, 0.66 +/- 0.25 in central islands group and 0.69 +/- 0.19, 0.78 +/- 0.19 in control group at 1 week after LASIK. The visual acuity in control group was more improved statistically significantly than central islands group (respectively p = 0.01, p = 0.03). There was no statistical significance between the two groups, although the uncorrected visual acuity and best corrected visual acuity were somewhat more increased in control group at 2 months and 6 months after LASIK than in central islands group (respectively p = 0.06, p = 0.24 at 2 months, p = 0.10, p = 0.17 at 6 months). On the changes of spherical equivalent after LASIK, both the central islands group and control group were in hyperopic state at 1 week after LASIK and were somewhat regressed to myopia at 2 months and 6 months after LASIK. But there was no statistical significance between the two groups at different time points (respectively p = 0.15, p = 0.64, p = 0.67). In 12 cases the central islands were disappeared spontaneously at 2 months, but in 3 cases the central islands were remained 6 months after LASIK on corneal topography. In the one case of 3 cases the best corrected visual acuity was 0.5 at 6 months after LASIK, but in the others the best corrected visual acuity was not different from the mean best corrected visual acuity. Most cases in LASIK, the central islands were dissapeared without specific treatments as in PRK. We suggest, in the case of central islands at 6 months after LASIK, that if the patient complain visual discomfort, monocular diplopia, haloes, or ghost images, central reablation with excimer laser should be considered.
中央岛被定义为在准分子激光应用于近视矫正后角膜地形图上的局部隆起区域。我们在使用VISX STAR进行LASIK术后1周的角膜地形图上观察到15例中央岛病例。LASIK术后1周，中央岛组的裸眼视力和最佳矫正视力分别为0.52±0.22、0.66±0.25，对照组分别为0.69±0.19、0.78±0.19。对照组的视力改善在统计学上显著优于中央岛组（p分别为0.01、0.03）。尽管在LASIK术后2个月和6个月时，对照组的裸眼视力和最佳矫正视力比中央岛组有所增加，但两组之间无统计学意义（2个月时p分别为0.06、0.24，6个月时p分别为0.10、0.17）。关于LASIK术后等效球镜度的变化，中央岛组和对照组在LASIK术后1周均处于远视状态，在LASIK术后2个月和6个月时有所回退至近视。但在不同时间点两组之间无统计学意义（p分别为0.15、0.64、0.67）。12例中央岛在2个月时自发消失，但3例在LASIK术后6个月角膜地形图上仍存在中央岛。在这3例中的1例，LASIK术后6个月最佳矫正视力为0.5，但其他2例最佳矫正视力与平均最佳矫正视力无差异。在大多数LASIK病例中，中央岛像PRK一样无需特殊治疗即可消失。我们建议，在LASIK术后6个月出现中央岛的情况下，如果患者主诉视觉不适、单眼复视、光晕或重影，应考虑用准分子激光进行中央再次消融。
