Anterior lamellar keratoplasty with a microkeratome: a method for managing complications after refractive surgery.
OBJECTIVE
To demonstrate a technique of anterior lamellar keratoplasty with standardized and automated preparation of surface-parallel cuts in both donor and recipient appropriate for addressing several problems after laser in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK).


METHODS
We report a noncomparative series of ten eyes with complications after LASIK and PRK. Lamellar cuts were performed in donor and recipient eyes by means of an automated microkeratome. Lamellar grafts were fixed by only four single sutures. In two eyes, a re-lift LASIK was performed after 6 months.


RESULTS
Surgery was uneventful and visual acuity was improved in all eyes. Residual irregular astigmatism and refractive error were corrected in two eyes by means of excimer laser computer-assisted ablation and resulted in a further improvement of uncorrected and best spectacle-corrected visual acuity.


CONCLUSIONS
Anterior lamellar keratoplasty with a microkeratome can be used for the management of certain complications of PRK and LASIK.
Hafezi
Farhad
F
Department of Ophthalmology, University Hospital Zurich, Switzerland.
Mrochen
Michael
M
Fankhauser
Franz
F
Seiler
Theo
T
D000328:Adult; D003315:Cornea / Q000473:pathology / Q000601:surgery*; D003316:Corneal Diseases / Q000209:etiology / Q000601:surgery*; D019781:Corneal Topography; D016039:Corneal Transplantation / Q000379:methods*; D005260:Female; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects*; D054018:Lasers, Excimer; D008875:Middle Aged; D018903:Photorefractive Keratectomy / Q000009:adverse effects*; D011183:Postoperative Complications / Q000601:surgery; D054140:Refractive Surgical Procedures; D016896:Treatment Outcome; D014792:Visual Acuity