title: Long-term refractive results of elliptical excimer laser penetrating keratoplasty (EELPK).
abstract: OBJECTIVE
  To assess long-term refractive and visual outcome of elliptical excimer laser penetrating keratoplasty (EELPK).
  
  
  METHODS
  Inclusion criteria (17 eyes): (1) Primary central elliptical excimer laser penetrating keratoplasty in phakic eyes; (2) No other simultaneous procedure except cataract surgery in 6 eyes; (3) Interrupted sutures; (4) Complete sequence of follow-ups before EELPK, with all-sutures-in, with all-sutures-out; (5) No active inflammation at the time of EELPK. Best corrected visual acuity (BCVA), refractive and keratometric astigmatism, topographic surface regularity index (SRI), surface asymmetry index (SAI) were determined in 5.9+/-3.3 years follow-up.
  
  
  RESULTS
  BCVA improved from 0.2 preoperatively to 0.6 after suture removal (p<0.001). After suture removal, keratometric (4.9D/5.8D, p=0.01) and refractive cylinder (2.8D/4.4D; p<0.001) increased, and SRI and SAI decreased significantly (3.0/1.0; 1.9/0.9; p=0.01) compared to all-suture-in values.
  
  
  CONCLUSIONS
  EELPK is effective in improving visual acuity. Despite topographic regularization, an increase of refractive more than keratometric astigmatism may occur after suture removal.
authors.affiliation: Department of Ophthalmology, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany. nszentmary@hotmail.com
authors.forename: Nóra
authors.initials: N
authors.lastname: Szentmáry
authors.forename: Achim
authors.initials: A
authors.lastname: Langenbucher
authors.forename: Murat M
authors.initials: MM
authors.lastname: Kus
authors.forename: Gottfried O H
authors.initials: GO
authors.lastname: Naumann
authors.forename: Berthold
authors.initials: B
authors.lastname: Seitz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001251:Astigmatism / Q000503:physiopathology*; D003315:Cornea / Q000503:physiopathology*; D003316:Corneal Diseases / Q000601:surgery; D019781:Corneal Topography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015948:Keratoplasty, Penetrating / Q000379:methods*; D054018:Lasers, Excimer; D008297:Male; D008875:Middle Aged; D012029:Refraction, Ocular / Q000502:physiology*; D012189:Retrospective Studies; D013536:Suture Techniques; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology*