Photorefractive keratectomy in african americans including those with known dermatologic keloid formation

PURPOSE: To report the outcome of photorefractive keratectomy in African Americans, including those with a known history of dermatologic keloid formation. METHODS: A retrospective analysis of African American patients who had photorefractive keratectomy at either of our institutions was undertaken to identify all patients who were at least 3 months status-post refractive surgery. The presence or absence of a history of keloid formation, as well as preoperative and postoperative measurements of uncorrected visual acuity, best-corrected visual acuity, manifest refraction, and the presence and magnitude of any postoperative corneal haze were analyzed. RESULTS: Twelve patients (19 eyes) met the inclusion criteria and three of these patients (six eyes) had a history of keloid formation. Mean uncorrected visual acuity ± SD for the entire study group improved from 20/369 ± 20/270 preoperatively to 20/19.4 ± 20/7.1 postoperatively (average follow-up, 13.8 months). All eyes had postoperative uncorrected visual acuity of 20/40 or better; 14 (74%) achieved 20/20 or better. Mean best spectacle corrected visual acuity went from 20/14.8 ± 20/2.8 preoperatively to 20/15.5 ± 20/3.2 postoperatively (not statistically significant). Mean manifest spherical equivalent was –4.9 ± 3.4 diopters preoperatively and +0.03 ± 0.55 diopters postoperatively. Eight eyes (42%) had trace to 1+ corneal haze following photorefractive surgery. A comparison of postoperative uncorrected and best-corrected visual acuities of known keloid formers with nonkeloid formers revealed no significant statistical difference. CONCLUSIONS: African Americans may have excellent visual outcomes following photorefractive keratectomy. History of keloid formation does not appear to have an adverse effect on the outcome. These results question whether known dermatologic keloid formation should be a contraindication to photorefractive keratectomy.