Epithelial photorefractive keratectomy as an enhancement procedure after laser in situ keratomileusis.

The authors describe the refractive effect of epithelial photorefractive keratectomy (E-PRK) on 10 eyes that had undergone LASIK (group 1) and 13 eyes that had not been operated on (group 2). The central 6 mm was ablated. The mean corneal epithelium removed was 15.64 +/- 8.703 microm in group 1 and 25.23 +/- 7.069 microm in group 2. In group 1, the mean postoperative best uncorrected visual acuity (BUCVA) was 1.24 +/- 0.344, which was sustained for a mean of 2.75 +/- 3.456 months and returned to the preoperative value in 6.1 +/- 4.61 months. In group 2, all patients reported severe ocular pain and the BUCVA decreased except for 2 patients whose eyes reached 1.0 at 1 week postoperatively. All eyes reached the preoperative BUCVA by 1 month. This method is contraindicated for previously unoperated corneas but may be useful to enhance post-LASIK eyes when standard enhancement surgery is problematic.