Subclinical inflammation after laser in situ keratomileusis in corneal grafts.
OBJECTIVE
To evaluate postoperative inflammatory reaction in the eye after laser in situ keratomileusis (LASIK) in corneal grafts.


METHODS
Department of Ophthalmology, Helsinki University Central Hospital, Helsinki, Finland.


METHODS
Ten eyes of 9 patients with penetrating keratoplasty (PKP) and significant postoperative refractive errors and astigmatism had LASIK 22 months or more after the PKP. All patients were treated with the VISX Star excimer laser and the Bausch & Lomb Hansatome microkeratome. Preoperative and early postoperative inflammation was evaluated by quantifying the aqueous flare intensity with a laser flare photometer (Kowa FM-500). A full ophthalmic assessment was also performed before LASIK and up to 6 months postoperatively.


RESULTS
The inflammatory response was mild and limited to the first postoperative hour. The mean anterior chamber flare increased from 6.0 photons/millisecond (ph/ms) preoperatively to 14.0 ph/ms at 1 hour and then decreased to 6.7 ph/ms (hour 3), 6.8 ph/ms (day 1), and 8.2 ph/ms (day 7). The mean spherical equivalent (SE) refraction decreased from -3.81 diopters (D) (range -9.63 to -0.25 D) to -0.46 D (range -1.13 to +0.38 D), and the mean preoperative astigmatism decreased from 3.0 D (range 6.5 to 0.5 D) to 0.7 D (range 0.0 to 2.0 D). At the last examination, 9 eyes were within +/-1.0 D (6 within +/-0.5 D) and all were within +/-1.5 D of the intended SE refraction. Three eyes achieved full cylinder correction, and 7 were within +/-1.0 D of the intended correction. Eight eyes had a best corrected visual acuity of 20/40 or better (unchanged or gain of 1 to 4 lines [6], loss of 1 line [1], and loss of 3 lines [1]), and 8 had an uncorrected visual acuity of 20/50 or better.


CONCLUSIONS
Uneventful LASIK induced subtle, short-lasting anterior chamber flare when measured by the laser flare meter. In corneal grafts, LASIK appeared to be a safe and effective procedure for residual refractive errors.
Sen
Hatice Nida
HN
Department of Ophthalmology, Helsinki University Central Hospital, Helsinki, Finland. senh@nei.nih.gov
Uusitalo
Risto
R
Laatikainen
Leila
L
D000328:Adult; D000368:Aged; D000867:Anterior Chamber / Q000473:pathology; D001251:Astigmatism / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D007634:Keratitis / Q000209:etiology* / Q000473:pathology; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects*; D015948:Keratoplasty, Penetrating / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D012030:Refractive Errors / Q000209:etiology; D054140:Refractive Surgical Procedures; D014606:Uveitis, Anterior / Q000209:etiology* / Q000473:pathology; D014792:Visual Acuity