Laser in situ keratomileusis for correction of myopia and astigmatism after penetrating keratoplasty.
OBJECTIVE
To determine the safety and effectiveness of laser in situ keratomileusis (LASIK) for visual rehabilitation of residual myopia and astigmatism after penetrating keratoplasty.


METHODS
Prospective, noncomparative case series.


METHODS
LASIK was performed on 23 eyes of 22 patients unable to wear glasses or contact lenses after penetrating keratoplasty due to anisometropia, high astigmatism, and/or contact lens-intolerance.


METHODS
All patients underwent LASIK for visual rehabilitation after penetrating keratoplasty. Uncorrected visual acuity and best spectacle-corrected visual acuity, degree of anisometropia, and corneal transplant integrity were recorded before surgery, as well as at 1 month, 3 months, 6 months, and 12 months after LASIK surgery.


RESULTS
The mean spherical equivalent before surgery was -7.58+/-4.42 diopters (D), which was reduced to -1.09+/-2.01 D, -0.79+/-1.84 D, -0.77+/-1.25 D, and -1.57+/-1.20 D, respectively, at 1, 3, 6, and 12 months after LASIK. The mean cylinder before surgery was 3.64+/-1.72 D, which was reduced to 1.98+/-1.15 D, 1.64+/-1.14 D, 1.48+/-0.92 D, and 1.29+/-1.04 D, respectively, at 1, 3, 6, and 12 months after LASIK. Spherical equivalent anisometropia was reduced from a mean of 6.88+/-4.4 D to 1.42+/-1.05 D at the final examination. Best-corrected visual acuity remained the same or improved in 21 of 23 eyes and decreased by 1 and 3 lines in 2 patients. There were no surgical flap or corneal transplant complications.


CONCLUSIONS
LASIK is a viable treatment alternative for myopia and astigmatism after penetrating keratoplasty in patients who are contact lens-intolerant. LASIK is more effective in treating myopia than astigmatism after penetrating keratoplasty.
Donnenfeld
E D
ED
Department of Ophthalmology, North Shore University Hospital, Manhasset, New York 11530, USA.
Kornstein
H S
HS
Amin
A
A
Speaker
M D
MD
Seedor
J A
JA
Sforza
P D
PD
Landrio
L M
LM
Perry
H D
HD
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001251:Astigmatism / Q000209:etiology / Q000601:surgery*; D002452:Cell Count; D003315:Cornea / Q000601:surgery*; D019781:Corneal Topography; D016039:Corneal Transplantation / Q000379:methods; D004728:Endothelium, Corneal / Q000166:cytology; D005260:Female; D006801:Humans; D015948:Keratoplasty, Penetrating / Q000009:adverse effects*; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000209:etiology / Q000601:surgery*; D011446:Prospective Studies; D012029:Refraction, Ocular; D013524:Surgical Flaps; D014792:Visual Acuity