Laser in situ keratomileusis after penetrating keratoplasty.
OBJECTIVE
To assess the outcomes of laser in situ keratomileusis (LASIK) after penetrating keratoplasty (PKP).


METHODS
Hospital de Clínicas de Porto Alegre, Department of Ophthalmology, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.


METHODS
Fourteen eyes of 13 patients who had LASIK after PKP were retrospectively reviewed. The interval between LASIK and PKP was at least 1 year, and the follow-up after LASIK was also at least 1 year. All patients had a stable refractive error for a minimum of 6 months after all sutures were removed, regular and symmetric topographic astigmatism, and a minimal ultrasonic central corneal pachymetry of 500 microm. The Chiron Automatic Corneal Shaper and the Meditec Aesculap MEL 60 excimer laser were used.


RESULTS
At 12 months, mean myopia decreased from -5.33 diopters (D) +/- 4.22 (SD) to 0.19 +/- 1.71 D, mean hyperopia decreased from +5.04 +/- 3.32 D to + 0.42 +/- 0.46 D, and mean astigmatism decreased from 5.37 +/- 2.12 D to 2.82 +/- 2.42 D (47.5% of mean percentage reduction). Retreatment was necessary in 42.9% of eyes because of cylindrical undercorrection. Uncorrected visual acuity improved in 11 eyes (78.6%). Best spectacle-corrected visual acuity improved in 6 eyes (42.8%) and was maintained in 4 eyes (28.6%); 5 eyes (35.7%) lost 1 Snellen line. Intraoperative complications included 1 buttonhole flap. Postoperative complications included interface epithelial ingrowth at the periphery (2 eyes) and pseudophakic retinal detachment 2 years after LASIK (1 eye).


CONCLUSIONS
Laser in situ keratomileusis after PKP safely and predictably corrected the spherical component of the refraction. However, the predictability of LASIK in correcting post-PKP astigmatism was poor.
Kwitko
S
S
Department of Ophthalmology, Hospital de Clínicas de Porto Alegre, Porto Alegre-RS, Brazil.
Marinho
D R
DR
Rymer
S
S
Ramos Filho
S
S
D000328:Adult; D003315:Cornea / Q000601:surgery*; D019781:Corneal Topography; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000601:surgery*; D006801:Humans; D007640:Keratoconus / Q000601:surgery*; D020731:Keratomileusis, Laser In Situ; D015948:Keratoplasty, Penetrating / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012030:Refractive Errors / Q000209:etiology; D054140:Refractive Surgical Procedures; D012086:Reoperation; D016896:Treatment Outcome