Cloud and fog deposition: Monitoring in high elevation and coastal ecosystems. The past, present, and future.

Collection methods critical load values and total nitrogen budgets for high-elevation and fog-impacted sites requires reliable cloud and fog water deposition estimates. The cost and labor intensity of cloud/fog water sample collection have made it difficult to conduct long-term studies that would provide the data needed to develop accurate estimates. Current understanding of fog formation, transport, and the role of fog and cloud deposition in hydrogeological and biogeochemical cycles is incomplete due, in part, to lack of a concerted interdisciplinary approach to the problem. Historically, these obstacles have limited interest in and collection of cloud and fog water samples. In addition to measurements of cloud/fog chemical composition, documenting fog/cloud deposition fluxes of pollutant and nutrient species requires knowledge of cloud/fog physical properties, frequency and duration of fog/cloud interception with landscapes, properties of vegetation on those landscapes, and properties of the wind that drive droplet/vegetation interactions. Because drop deposition efficiency is dependent on drop size, it is also important to consider variations in fog/cloud drop composition with drop size as species enriched in larger/ smaller drops will experience enhanced/reduced deposition rates. This paper presents summary results from a small U.S. cloud water monitoring network that operated from the mid-nineties through 2011, as well as a brief qualitative review of other cloud and fog water studies conducted in the United States (including Puerto Rico), Europe, South America/Pacific, and Asia. Current collection methods are also reviewed. Recent scientific efforts by the National Atmospheric Deposition Program's (NADP) Total Deposition Science Committee and NADP's Critical Loads of Atmospheric Deposition Science Committee have identified occult (cloud/fog) deposition as a "need" in developing critical loads for ecosystems that experience.

A statistical comparison of active and passive ammonia measurements collected at Clean Air Status and Trends Network (CASTNET) sites.

Atmospheric concentrations of ammonia (NH3) are not well characterized in the United States due to the sparse number of monitors, the relatively short lifetime of NH3 in the atmosphere, and the difficulty in measuring non-point source emissions such as fertilized agricultural land. In this study, we compare measured weekly concentrations of NH3 collected by two denuder systems with a bi-weekly passive NH3 sampler used by the National Atmospheric Deposition Program's (NADP) Ammonia Monitoring Network (AMoN). The purpose of the study was to verify the passive samplers used by AMoN and characterize any uncertainties introduced when using a bi-weekly versus weekly sampling time period. The study was conducted for 1 year at five remote Clean Air Status and Trends Network (CASTNET) sites. Measured ambient NH3 concentrations ranged from 0.03 µg NH3 m(-3) to 4.64 µg NH3 m(-3) in upstate New York and northwest Texas, respectively, while dry deposition estimates ranged from 0.003 kg N ha(-1) wk(-1) to 0.47 kg N ha(-1) wk(-1). Results showed that the bi-weekly passive samplers performed well compared to annular denuder systems (ADS) deployed at each of the five CASTNET sites, while the MetOne Super SASS Mini-Parallel Plate Denuder System (MPPD) was biased low when compared to the ADS. The mean relative percent difference (MRPD) between the ADS and MPPD and the ADS and AMoN sampler was -38% and -9%, respectively. Precision of the ADS and MPPD was 5% and 13%, respectively, while the precision of the passive samplers was 5%. The results of this study demonstrate that the NH3 concentrations measured by AMoN are comparable to the ADS and may be used to supplement the high-time resolution measurements to gain information on spatial gradients of NH3, long-term trends and seasonal variations in NH3 concentrations.

Use of fecundity measured directly throughout the breeding season to test a source-sink demographic model.

Populations of landbirds (bird species that occupy terrestrial habitats for most of their life cycle) are declining throughout North America (north of Mexico) and Europe, yet little is known about how demography is driving this trend. A recent model of 5 geographically separated populations of Cerulean Warblers (Dendroica cerulea) that was based on within-season sampling of nest survival and fledgling success shows that all populations are sinks (annual reproduction is consistently less than annual adult mortality). I tested this indirect model by directly measuring fecundity (number of female fledglings/female) during the breeding season for 2 years in a Cerulean Warbler population occupying a mature forest in southwestern Michigan (U.S.A.) I determined territories of male birds on the basis of male plumage characters and phases of the nesting cycle (2007) and on uniquely color-banded males (2008). I transferred locations of identified males to topographic maps. I counted all fledglings in territories from May to July each year. The model I tested may apply only to single-brooded species; therefore, I searched the literature to estimate the percentage of single-brooded species in North America. The breeding season of Cerulean Warblers was short- nearly all nests were initiated from mid-May to late June. Nest predation and brood parasitism were primary and rare causes of nest failure, respectively. Significantly fewer Cerulean Warblers fledged from parasitized than from nonparasitized nests. Fledgling survival required to maintain the population size was well above previously published values for Neotropical migrants. Single-brooded species comprise 62% of North American breeding bird species for which the number of broods per year is known; I believe my results may apply to these species. The consistency between identification of populations as sources or sinks on the basis of either model estimates or direct measurements suggests that a demographic model relying on within-season sampling of fecundity is adequate to determine population status of single-brooded avian populations. In addition, on the basis of results of previous studies, annual adult survival rate of the Cerulean Warbler is typical of parulid warblers that are not declining. Thus, low fecundity, here determined with different quantitative methods, can drive status of landbird species with high-observed survival.

Resumen: Las poblaciones de aves terrestres (especies de aves que ocupan hábitats terrestres durante la mayor parte de su ciclo de vida) están declinando en Norte América (al norte de México) y Europa, pero se conoce poco la manera en que la demografía esta dirigiendo esta tendencia. Un modelo reciente de 5 poblaciones de Dendorica caerulea separadas geográficamente basado en muestreos de supervivencia de nidos y éxito de volantones muestra que todas las poblaciones son sumideros (la reproducción anual es consistentemente menor a la mortalidad anual de adultos). Probéeste modelo indirecto mediante la medición directa de la fecundidad (número de volantones hembra/hembra) durante la época de reproducción durante 2 años en una población de D. caerulea en un bosque maduro en el suroeste de Michigan (E.U.A.). Determiné los territorios de machos con base en características del plumaje de machos y etapas del ciclo de nidificación en (2007) y en machos con anillos de colores (2008). Transferí las localidades de machos identificados a mapas topográficos. Conté todos los volantones en territorios en mayo-julio cada año. El modelo que probé puede aplicar solo a especies con una nidada; por lo tanto, revisé la literatura para estimar el porcentaje de especies con una nidada en Norte América. La época de reproductiva de D. caerulea fue corta: casi todos los nidos fueron iniciados a mediados de mayo a fines de junio. La depredación y parasitismo de nidos fueron las causas primarias y raras del fracaso de la nidada, respectivamente. Significativamente menos D. caerulea volaron de nidos parasitados que de nidos no parasitados. La supervivencia de volantones requerida para mantener el tamaño poblacional estuvo muy por arriba de los valores publicados previamente para migrantes Neotropicales. Las especies con una nidada comprenden 62% de las especies norteamericanas cuyo número de nidadas por año es conocido; considero que mis resultados pueden ser aplicados a estas especies. La consistencia entre la identificación de poblaciones como fuente o vertedero con base en estimaciones de modelos o medidas directas sugiere que un modelo demográfico basado en muestreos de la fecundidad es adecuado para determinar el estatus demográfico de poblaciones aviares con una sola nidada. Adicionalmente, con base en los resultados de estudios previos, la tasa anual de supervivencia de adultos de D. caerulea es típica de parúlidos que no están declinando. Por lo tanto, la fecundidad baja, determinada aquí con métodos cuantitativos diferentes, puede influir en el estatus de especies de aves terrestres con alta supervivencia observada.

Intercomparison of Clean Air Status and Trends Network Nitrate and Nitric Acid Measurements with Data from Other Monitoring Programs.

The U.S. Environmental Protection Agency Clean Air Status and Trends Network (CASTNET) utilizes an open-face filter pack system to measure concentrations of atmospheric sulfur and nitrogen species. Concentration data for nitrogen species measured with filter pack systems sometimes deviate from data collected by other measurement systems used to measure the same species. The nature of these differences suggests that more than one sampling mechanism or atmospheric process is involved. The study presented here examines these differences by intercomparing CASTNET data with data from other studies, examining the results from earlier intercomparison studies, and conducting a field test to investigate the effect of particle size on filter pack measurement systems. Measurements of nitrogen species from the Maryland Aerosol Research and Characterization (MARCH) monitoring site were compared with nitrogen concentrations at three nearby CASTNET sites. Results indicate that CASTNET measured higher particulate nitrate (NO3-) and lower gaseous nitric acid (HNO3) concentrations. Comparisons of NO3- from 34 collocated CASTNET and Inter-agency Monitoring of Protected Visual Environments (IMPROVE) sites show that CASTNET NO3- measurements were typically higher than the corresponding IM PROVE values. Also, results from the Lake Michigan Air Director's Consortium Midwest Ammonia Monitoring Project demonstrated NO3- dissociation on Teflon filters. To investigate the effect of particle size, filter pack measurement systems were operated at three CASTNET sites with and without cyclones during six 7-day measurement periods from March to August 2006. Results indicate the size-selection cyclones had a significant effect on both NO3- and HNO3 concentrations, but little effect on sulfate (SO42-) and ammonium (NH4+) levels. NO3- concentrations sampled with the open-face filters were significantly higher than concentrations measured with a 2.5-µm cut point, as were HNO3 concentrations. Although limited in spatial and temporal coverage, the field study showed that the use of an open-face filter pack may allow for the collection of coarse NO3- particles and for the reaction of HNO3 with metals/salts on the Teflon filter.

West Nile virus antibodies in permanent resident and overwintering migrant birds in south-central Kansas.

UNLABELLED: We conducted serological studies, using epitope-blocking ELISAs directed at West Nile virus (WNV) and flavivirus antibodies, of wild birds in south-central Kansas, the first for this state, in the winters of 2003-04 through 2005-06. Overwintering migratory species (primarily the American tree sparrow and dark-eyed junco) consistently showed significantly lower seropositivity than permanent residents (primarily the northern cardinal). The cardinal showed annual variation in seropositivity between winters. Of 35 birds that were serial sampled within a single winter, one cardinal may have seroconverted between late December and mid-February, providing a preliminary suggestion of continued enzootic transmission, chronic infection, or bird-bird transfer as overwintering mechanisms. Breeding population size of the cardinal did not change after the introduction of WNV to Kansas. Of eighteen birds that were serial sampled between winters, none seroconverted. Among overwintering migrants, the Harris' Sparrow showed the highest seropositivity, possibly related to its migration route through the central Great Plains, an area of recent high WNV activity. The finding that permanent resident birds exhibit higher seropositivity than migrant birds suggests that resident birds contribute to the initiation of annual infection cycles,although this conclusion is speculative in the absence of data on viral titers and the length of viremia. KEYWORDS: West Nile Virus-flavivirus-birds-epitope-blocking ELISA-winter.

LASIK flap interface deposition in limbal vernal keratoconjunctivitis.

Limbal vernal keratoconjunctivitis (VKC) is an uncommon chronic allergic eye disease. It is generally seen in young males and is characterised by limbal papillae and superficial keratitis. While the condition usually resolves with age, treatment is necessary to alleviate symptoms and reduce the risk of permanent corneal damage. A 25-year-old male presents with recurrent red, itchy eyes. He had undergone an uncomplicated bilateral LASIK procedure five years previously. Slitlamp examination shows limbal chemosis, superficial keratitis and an unusual yellow-white deposition that tracks along the superior LASIK flap interface. A diagnosis is made of limbal VKC with an altered corneal response associated with previous LASIK. Treatment with intensive topical steroids led to resolution of his limbal and corneal inflammation, leaving the deposition unchanged.

TACE/ADAM-17: a component of the epidermal growth factor receptor axis and a promising therapeutic target in colorectal cancer.

PURPOSE: Activation of the epidermal growth factor receptor (EGFR) requires cell surface cleavage of EGFR ligands, uptake of soluble ligand by the receptor, and initiation of EGFR tyrosine kinase activity. We define these collective events as the EGFR axis. Transforming growth factor-alpha (TGF-alpha) and amphiregulin are two EGFR ligands that are delivered preferentially to the basolateral surface of polarized epithelial cells where the EGFR resides. TACE/ADAM-17 (tumor necrosis factor-alpha converting enzyme/a disintegrin and metalloprotease) has been implicated in ectodomain cleavage of TGF-alpha and amphiregulin. EXPERIMENTAL DESIGN: Using a human polarizing colorectal cancer (CRC) cell line, HCA-7, and a tissue array of normal colonic mucosa and primary and metastatic CRC, we determined the intracellular localization of TACE and the effects of EGFR axis inhibition in CRC. RESULTS: Herein, we show that TACE is localized to the basolateral plasma membrane of polarized HCA-7 cells. TACE is overexpressed in primary and metastatic CRC tumors compared with normal colonic mucosa; the intensity of its immunoreactivity is inversely correlated with that of TGF-alpha and amphiregulin. Pharmacologic blockade of HCA-7 cells with an EGFR monoclonal antibody, a selective EGFR tyrosine kinase inhibitor, and a selective TACE inhibitor results in concentration-dependent decreases in cell proliferation and active, phosphorylated mitogen-activated protein kinase. Combining suboptimal concentrations of these agents results in cooperative growth inhibition, increased apoptosis, and reduced mitogen-activated protein kinase pathway activation. Furthermore, an EGFR tyrosine kinase-resistant clone of HCA-7 cells is growth-inhibited by combined monoclonal antibody and TACE inhibition. CONCLUSION: These results implicate TACE as a promising target of EGFR axis inhibition in CRC.

Ligand-dependent activation of the epidermal growth factor receptor by secondary bile acids in polarizing colon cancer cells.

BACKGROUND: Secondary bile acids such as deoxycholic acid (DCA) are known to promote colorectal cancer (CRC). Increasing evidence suggests that DCA-induced signaling is mediated by activation of the epidermal growth factor receptor (EGFR). We have shown that activation of the EGFR induces up-regulation of cyclooxygenase 2, basolateral release of prostaglandins (PGs), and mitogenesis in a polarizing human colon cancer cell line, HCA-7. The purpose of this study was to determine the mechanism by which DCA activates EGFR in human polarizing CRC cell lines HCA-7 and HCT-8. METHODS: A primary, non-tumor-promoting bile acid (cholic acid [CA]) and a secondary, tumor-promoting bile acid, DCA, were added to the apical and basolateral compartment of polarized HCA-7 and HCT-8 cells. These cells were pretreated with monoclonal antibody 528, a monoclonal antibody that inhibits ligand binding to EGFR, or with WAY-022, a selective inhibitor of tumor necrosis factor-alpha converting enzyme/a disintegrin and metalloprotease-17 (TACE/ADAM-17), which cleaves amphiregulin (AR) to its mature, soluble form from the basolateral cell membrane. AR levels were measured in the apical and basolateral medium and cell lysates by radioimmunoassay. PGs were measured in the apical and basolateral medium by gas chromatography/mass spectrometry. RESULTS: Basolateral delivery of DCA, but not CA, preferentially stimulated release of AR into the basolateral medium compared with cell lysates of polarized HCA-7 and HCT-8 cells. Basolateral delivery of DCA resulted in increased basolateral PGE2 levels (P < .05), and this effect was attenuated by pretreatment with monoclonal antibody 528 (P < .05). Inhibiting cell surface cleavage of AR with WAY-022 before DCA treatment reduced AR (P < .05) and PGE2 (P < .05) levels in the basolateral medium. CONCLUSION: DCA, but not CA, results in compartment-specific, ligand-dependent activation of EGFR and subsequent increased basolateral PGE2 levels. The mechanism of DCA-induced EGFR activation is ligand-dependent and is controlled, at least in part, at the level of AR release from the basolateral cell membrane.

Laser in situ keratomileusis for refractive error after cataract surgery.

PURPOSE: To evaluate the safety and efficacy of laser in situ keratomileusis (LASIK) to correct refractive error following cataract surgery. SETTING: The Eye Institute, Sydney, Australia. METHODS: This retrospective study reviewed 23 eyes (19 patients; 10 female, 9 male) treated with LASIK for refractive error following cataract surgery. The Summit Apex Plus and Ladarvision excimer laser and the SKBM microkeratome were used. The mean age was 63.5 years (range 50 to 88 years). The mean length of follow-up was 8.4 months (range 1 to 12 months) and mean interval between cataract surgery and LASIK was 12 months (range 2.5 to 46 months). RESULTS: The mean preoperative spherical equivalent refraction (SEQ) for myopic eyes was -3.08 +/- 0.84 diopters (D) (range -4.75 to -2.00 D) and for hyperopic eyes was +1.82 +/- 1.03 D (range +0.75 to +3.00 D). The mean improvement following LASIK surgery was greater for myopic than hyperopic eyes (myopic, 2.54 +/- 1.03 D versus hyperopic, 1.73 +/- 0.62 D; P=.033). The percentage of patients within +/-0.5 D of intended refraction post-LASIK surgery was 83.3% for myopic eyes and 90.9% for hyperopic eyes and all eyes were within +/-1.0 D of intended (P<.001). The percentage of eyes with uncorrected visual acuity of 20/40 or better in the myopic group improved from none preoperatively to 91.7% postoperatively (P<.001) and in the hyperopic group improved from 27.3% preoperatively to 90.9% postoperatively (P=.008). No eyes lost 2 or more lines of best corrected visual acuity. CONCLUSION: Laser in situ keratomileusis appears to be effective in correcting refractive error following cataract surgery. Longer-term studies are required to determine refractive stability.

Development of a questionnaire to assess subjective vision score in myopes seeking refractive surgery.

PURPOSE: To assess vision in patients with myopia and myopic astigmatism before and after refractive surgery. METHODS: A prospective controlled study of visual quality amongst myopes and astigmatic myopes. Focus groups, ophthalmic surgeons, and questionnaire experts devised a Subjective Vision Questionnaire (SVQ), modified after a pilot trial. Participants were administered the SVQ before clinical evaluation. Items answered by over 95%, with factor loadings > 0.55 were included. Test-retest reliability was assessed by repeat testing. Factor analysis identified groups of questions measuring particular dimensions of data. RESULTS: Sixty-seven items were answered by 128 patients and reduced to 24 items in a final questionnaire. Factor analysis identified six types of questions within the questionnaire, the most important of which was related to driving. CONCLUSION: The simplicity, low cost, and psychometric properties of the Subjective Vision Questionnaire support its use clinically and in research.

Laser in situ keratomileusis with Alcon CustomCornea.

PURPOSE: To report the 3-month results of our first cases of laser in situ keratomileusis (LASIK) with Alcon's CustomCornea. METHODS: Wavefront analysis was performed using the LADARWave aberrometer and ablation was performed with the LADARVision4000 system. Thirty-one eyes of 17 patients were analyzed prospectively, at 1 and 3 months after CustomCornea surgery. Psychophysical tests were performed, including high and low contrast acuity, and contrast sensitivity under scotopic and photopic conditions. In addition, psychometric testing was performed using a subjective vision questionnaire. RESULTS: Mean spherical equivalent refraction improved from a baseline -3.05 +/- 1.92 D to +0.02 +/- 0.28 D at 3 months (28 eyes). At 3 months, 46.4% (13 eyes) had uncorrected visual acuity of 20/16, 92.7% (26 eyes) had 20/20, and 100% (28 eyes) had 20/25 uncorrected visual acuity. Three months after CustomCornea surgery, there was a statistically significant improvement in contrast sensitivity under both scotopic and photopic conditions, and a statistically significant increase in third and fourth order aberrations. There was a statistically significant improvement in visual quality as measured by the subjective vision index, increasing from a preoperative mean 66.62 to 87.63 at 3 months after surgery. CONCLUSIONS: CustomCornea was an improvement over conventional LASIK as measured by most psychophysical and psychometric parameters. The relationship between higher order aberrations and other psychophysical and psychometric measurements needs more analysis.

Estimates of cloud water deposition at Mountain Acid Deposition Program sites in the Appalachian Mountains.

Cloud water deposition was estimated at three high-elevation sites in the Appalachian Mountains of the eastern United States (Whiteface Mountain, NY; Whitetop Mountain, VA; and Clingman's Dome, TN) from 1994 through 1999 as part of the Mountain Acid Deposition Program (MADPro). This paper provides a summary of cloud water chemistry, cloud liquid water content, cloud frequency, estimates of cloud water deposition of sulfur and nitrogen species, and estimates of total deposition of sulfur and nitrogen at these sites. Other cloud studies in the Appalachians and their comparison to MADPro are also summarized. Whiteface Mountain exhibited the lowest mean and median concentrations of sulfur and nitrogen ions in cloud water, while Clingman's Dome exhibited the highest mean and median concentrations. This geographic gradient is partly an effect of the different meteorological conditions experienced at northern versus southern sites in addition to the difference in pollution content of air masses reaching the sites. All sites measured seasonal cloud water deposition rates of SO4(2-) greater than 50 kg/ha and NO3(-) rates of greater than 25 kg/ha. These high-elevation sites experienced additional deposition loading of SO4(2-) and NO3(-) on the order of 6-20 times greater compared with lower elevation Clean Air Status and Trends Network (CASTNet) sites. Approximately 80-90% of this extra loading is from cloud deposition.

The effect of laser-assisted in situ keratomileusis on retinal nerve fiber layer measurements obtained with scanning laser polarimetry.

PURPOSE: Scanning laser polarimetry provides indirect measurements of retinal nerve fiber layer thickness by measuring the retardation of polarized laser light as it passes through the retinal nerve fiber layer. Laser-assisted in situ keratomileusis is a refractive technique by which corneal stromal photoablation is achieved by the structural and refractive changes induced by the excimer laser. Both techniques are becoming widely performed and there is some evidence that scanning laser polarimetry measurements are significantly changed after laser-assisted in situ keratomileusis. The authors performed a larger study to determine whether laser-assisted in situ keratomileusis induces predictable and consistent alterations in the measurement of retinal nerve fiber layer thickness. METHODS: Retinal nerve fiber layer thickness measurements using scanning laser polarimetry were performed 1 week before and 1 week after laser-assisted in situ keratomileusis in 30 consecutive eyes (16 patients) undergoing the procedure at The Eye Institute. RESULTS: Mean +/- SD preoperative spherical equivalent refraction was -4.66 +/- 2.40 D, mean ablation depth was 73.0 +/- 36.23 microm, and mean patient age was 40.6 +/- 8.7 years. Six of 12 retinal nerve fiber layer thickness measurements showed significant change (P < 0.05) after laser-assisted in situ keratomileusis. There was no correlation with corneal ablation depth (P > 0.05) for all parameters. CONCLUSION: Laser-assisted in situ keratomileusis significantly affects retinal nerve fiber layer thickness measurements obtained by scanning laser polarimetry. Sequential images should be interpreted with caution and new postoperative baseline images should be obtained.

Estimates of the atmospheric deposition of sulfur and nitrogen species: Clean Air Status and Trends Network 1990-2000.

The Clean Air Status and Trends Network (CASTNet) was established by the U.S. EPA in response to the requirements of the 1990 Clean Air Act Amendments. To satisfy these requirements CASTNet was designed to assess and report on geographic patterns and long-term, temporal trends in ambient air pollution and acid deposition in order to gauge the effectiveness of current and future mandated emission reductions. This paper presents an analysis of the spatial patterns of deposition of sulfur and nitrogen pollutants for the period 1990-2000. Estimates of deposition are provided for two 4-yr periods: 1990-1993 and 1997-2000. These two periods were selected to contrast deposition before and after the large decrease in SO2 emissions that occurred in 1995. Estimates of dry deposition were obtained from measurements at CASTNet sites combined with deposition velocities that were modeled using the multilayer model, a 20-layer model that simulates the various atmospheric processes that contribute to dry deposition. Estimates of wet deposition were obtained from measurements at sites operated bythe National Atmospheric Deposition Program. The estimates of dry and wet deposition were combined to calculate total deposition of atmospheric sulfur (dry SO2, dry and wet SO4(2-)) and nitrogen (dry HNO3, dry and wet NO3-, dry and wet NH4+). An analysis of the deposition estimates showed a significant decline in sulfur deposition and no change in nitrogen deposition. The highest rates of sulfur deposition were observed in the Ohio River Valley and downwind states. This region also observed the largest decline in sulfur deposition. The highest rates of nitrogen deposition were observed in the Midwest from Illinois to southern New York State. Sulfur and nitrogen deposition fluxes were significantly higher in the eastern United States as compared to the western sites. Dry deposition contributed approximately 38% of total sulfur deposition and 30% of total nitrogen deposition in the eastern United States. Percentages are similar for the two 4-yr periods. Wet sulfate and dry SO2 depositions were the largest contributors to sulfur deposition. Wet nitrate, wet ammonium, and dry HNO3 depositions were the largest contributors to nitrogen deposition.

Laser in situ keratomileusis for residual myopia after photorefractive keratectomy.

PURPOSE: To evaluate the efficacy and safety of laser in situ keratomileusis (LASIK) for myopic regression and undercorrection after photorefractive keratectomy (PRK). SETTING: The Eye Institute, Sydney, Australia. METHODS: Fifty eyes of 32 patients were treated by LASIK for residual myopia following primary PRK. The mean spherical equivalent refraction (SEQ) was -2.92 diopters (D) +/- 1.57 (SD) (range -0.75 to -7.88 D). The mean refractive cylinder was 0.96 +/- 0.74 D (range 0 to 3.50 D). For analysis, the eyes were divided into 2 groups: those with 0 or low corneal haze (Group 1) and those with severe corneal haze (Group 2). In Group 1, the SEQ was -1.99 +/- 0.79 D (range -0.75 to -3.75 D) and in Group 2, -3.77 +/- 1.62 D (range -0.75 to -7.90 D). The procedure was performed using the Chiron Automated Corneal Shaper and the Summit Apex Plus laser. The mean interval between PRK and LASIK was 25 months (range 9 to 59 months). The following parameters were studied before and after LASIK retreatment: SEQ, mean refractive cylinder, uncorrected visual acuity (UCVA), and best corrected visual acuity (BCVA). Complications after LASIK retreatment were evaluated. RESULTS: Six months after LASIK, the mean SEQ in all eyes was -0.65 +/- 0.86 D (range +1.50 to -3.35 D); 70.0% of eyes were within +/-1.00 D of emmetropia and the UCVA was 6/12 or better in 72.5%. The mean SEQ in Group 1 was -0.22 +/- 0.55 D (range -0.88 to -1.50 D) and in Group 2, -0.97+/- 0.92 D (range 0.12 to -3.25 D); the UCVA was 6/12 or better in 94.0% of eyes in Group 1 and in 56.0% in Group 2. No statistically significant between-group difference was found in lines of Snellen acuity lost or gained at 6 months. No eye lost more than 1 line of BCVA. CONCLUSIONS: Laser in situ keratomileusis appears to be a safe, effective, and predictable procedure for treating eyes with 0 or low haze with residual myopia after PRK. It is less predictable in eyes with severe haze.