Excimer laser in situ keratomileusis.
We have been using a 193-nm excimer laser under protocol to ablate the corneal stromal bed after creating a hinged corneal flap with a microkeratome in order to reduce or eliminate refractive error. Thirty-one consecutive eyes are reviewed with a preoperative mean spherical equivalent refraction of -6.25 diopters (D) (range -3.50 to -11.75 D). Preoperative mean astigmatism was +0.87 D (range +0.25 to +2.75 D). At 6 months postoperatively, the mean spherical equivalent refraction was -0.50 D (range -3.50 to +2.00 D). Mean postoperative astigmatism was 0.64 D (range 0.25 to 3.50 D). A result within 1.00 D of attempted correction was achieved in 74.2% of eyes. Uncorrected visual acuity after a single procedure was 20/40 or better in 81% of eyes. Spectacle corrected visual acuity was unchanged in 26 (84%), decreased 1/2 line in 2 (6%), and increased 2 lines in 1 (3%). The incidence of postoperative complications was minimal. Excimer laser ablation in the stromal bed in combination with a hinged corneal flap seems to offer many advantages over excimer laser surface ablation with fewer complications.
Kremer
F B
FB
Kremer Laser Eye Center, Radnor, Pa 19087, USA.
Dufek
M
M
D001251:Astigmatism / Q000503:physiopathology; D003319:Corneal Stroma / Q000601:surgery*; D005139:Eyeglasses; D005260:Female; D006801:Humans; D054018:Lasers, Excimer; D008297:Male; D009216:Myopia / Q000503:physiopathology / Q000601:surgery*; D018903:Photorefractive Keratectomy / Q000379:methods*; D011183:Postoperative Complications; D012029:Refraction, Ocular; D013524:Surgical Flaps; D014792:Visual Acuity / Q000502:physiology