title: [Wavefront-guided lasek after intacs in eyes with stable keratoconus].
abstract: BACKGROUND
  Keratoconus is a non-inflammatory, progressive thinning disorder of the cornea, resulting in a typical protrusion and in refractive errors and low visual acuity. Many of the patients with stable keratoconus encounter difficulties wearing glasses or contact lenses.
  
  
  OBJECTIVE
  To evaluate the results of wave-front guided laser assisted subepithelial keratectomy (LASEK) for the correction of residual spherical and spherocylindrical myopia after INTACS insertion in patients with stable keratoconus.
  
  
  METHODS
  Four eyes of keratoconus patents were treated with Zyoptix wavefront-guided LASEK for correction of residual myopia and astigmatism after insertion of INTACS. The refraction after insertion of INTACS was stable at least six months before the Zyoptix-LASEK. The mean pre-INTACS refraction was myopia of -2.37 D (range 0 to - 5.00 D) and astigmatism of -3.93 D (range -1.00 to -7.5 D). The mean refraction prior to Zyoptix-LASEK was myopia of -0.2 D and astigmatism of -2.71 D. The mean follow-up period after the Zyoptix LASEK was 8 months.
  
  
  RESULTS
  Initially, prior to both surgeries, the mean uncorrected visual acuity was 6/240 (range count-fingers to 6/60) and at the final postoperative visit 6/12 (range 6/10 to 6/ 18). The preoperative mean best spectacle corrected visual acuity was 6/15 (range 6/10 to 6/24) and at the final postoperative follow-up visit 6/9 (range 6/8.5 to 6/12).
  
  
  CONCLUSIONS
  Zyoptix wavefront-guided LASEK for correction of residual myopia and astigmatism in keratoconus patients after INTACS insertion and stable refraction provided excellent visual outcome, with no loss of visual acuity and no complications.
authors.affiliation: Enaim Refractive Surgery Centers, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Hashomer, Israel. amitami@netvision.net.il
authors.forename: Ami
authors.initials: A
authors.lastname: Hirsh
authors.forename: Irina S
authors.initials: IS
authors.lastname: Barequet
authors.forename: Samuel
authors.initials: S
authors.lastname: Levinger
mesh_terms: D001251:Astigmatism / Q000601:surgery; D006801:Humans; D007640:Keratoconus / Q000601:surgery*; D020731:Keratomileusis, Laser In Situ / Q000295:instrumentation / Q000379:methods*; D009216:Myopia / Q000601:surgery; D012029:Refraction, Ocular; D016896:Treatment Outcome; D014792:Visual Acuity