Laser in situ keratomileusis for the correction of residual ametropia after penetrating keratoplasty.
OBJECTIVE
To evaluate the safety, efficacy, and predictability of excimer laser in situ keratomileusis (LASIK) to correct residual myopia and astigmatism after penetrating keratoplasty (PKP).


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


METHODS
Twenty-six eyes had LASIK at least 1 year after PKP. All eyes were followed for at least 6 months after LASIK; 22 eyes were followed for 12 months. Sutures were removed at a mean of 13 months post PKP. Laser in situ keratomileusis was performed with the Chiron Automated Corneal Shaper microkeratome (Bausch & Lomb) and the Visx Star excimer laser. Before LASIK, the mean spherical equivalent (SE) was -4.94 diopters (D) +/- 2.79 (SD) and the mean astigmatism was 2.71 +/- 2.33 D; all eyes had regular astigmatism or slightly decentered, irregular astigmatism.


RESULTS
At the last follow-up, the mean postoperative uncorrected visual acuity (UCVA) was 20/30, the mean SE was -0.35 +/- 0.65 D, and the mean residual astigmatism was 1.06 +/- 0.67 D. Eighty-six percent of patients had an SE within +/-1.00 D of emmetropia and a UCVA of 20/40 or better. Ten eyes (39%) had 1 or more enhancements, which were performed a mean of 6 months after the primary LASIK. Significant complications such as wound dehiscence, epithelial ingrowth, and corneal decompensation did not occur. At the last follow-up, 18% of patients lost 1 line of best corrected visual acuity and 27% gained 1 line.


CONCLUSIONS
Laser in situ keratomileusis appeared to be a reliable and safe procedure to correct residual myopia and astigmatism after PKP.
Buzard
Kurt
K
Department of Surgery, University of Nevada School of Medicine, Las Vegas, NV, USA.
Febbraro
Jean-Luc
JL
Fundingsland
Bradley R
BR
D000328:Adult; D000368:Aged; D001251:Astigmatism / Q000209:etiology / Q000601:surgery*; D019781:Corneal Topography; D003320:Corneal Ulcer / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D007640:Keratoconus / Q000601:surgery; D020731:Keratomileusis, Laser In Situ / Q000379:methods*; D015948:Keratoplasty, Penetrating; D008875:Middle Aged; D009216:Myopia / Q000209:etiology / Q000601:surgery*; D011183:Postoperative Complications / Q000601:surgery*; D011446:Prospective Studies; D012029:Refraction, Ocular; D012449:Safety; D013997:Time Factors; D014792:Visual Acuity