Treatment of mild to moderate keratoconus with laser in situ keratomileusis.
OBJECTIVE
To evaluate the effectiveness, stability, and complications of laser in situ keratomileusis (LASIK) to treat myopic astigmatism in patients with keratoconus.


METHODS
Buzard Eye Institute, Las Vegas, Nevada, USA.


METHODS
This study included 16 eyes of 9 patients who had keratometric and/or clinical evidence of keratoconus. Mean age was 45 years, and refraction was stable for at least 2 years. Two treatment approaches were evaluated.


RESULTS
Mean preoperative spherical equivalent was -4.23 diopters (D) +/- 2.14 (SD) with a mean steep keratometry of 46.81 +/- 3.07 D. Mean preoperative keratometric cylinder was 3.08 +/- 2.22 D. Mean postoperative keratometric cylinder was 3.00 +/- 4.78 D and mean spherical equivalent, -0.44 +/- 0.86 D. Mean postoperative steep keratometry was 44.12 +/- 7.17 D. Two eyes lost 1 line of best corrected visual acuity (BCVA), 1 eye lost 3 lines, and 2 lost 4 lines. Penetrating keratoplasty (PKP) was scheduled in 3 eyes 1 to 2 years after the primary LASIK.


CONCLUSIONS
The initial visual results appear promising; but longer term results revealed regression of the refractive outcome in some cases. Moreover, despite improvement in the postoperative spherical equivalent and uncorrected visual acuity in most cases, the risk of loss of BCVA and the necessity of performing PKP in 3 cases lead us not to consider LASIK as a primary solution for keratoconus.
Buzard
K A
KA
Division of Ophthalmology, University of Nevada School of Medicine, Las Vegas, USA.
Tuengler
A
A
Febbraro
J L
JL
D000328:Adult; D000368:Aged; D003315:Cornea / Q000473:pathology / Q000601:surgery*; D019781:Corneal Topography; D006801:Humans; D007640:Keratoconus / Q000473:pathology / Q000601:surgery*; D020731:Keratomileusis, Laser In Situ; D008875:Middle Aged; D009216:Myopia / Q000473:pathology / Q000601:surgery*; D012029:Refraction, Ocular; D016896:Treatment Outcome; D014792:Visual Acuity