title: Laser in situ keratomileusis to manage refractive errors after deep anterior lamellar keratoplasty.
abstract: OBJECTIVE
  To analyze the visual and refractive outcomes of laser in situ keratomileusis (LASIK) after deep anterior lamellar keratoplasty (DALK) for keratoconus.
  
  
  METHODS
  Haydarpasa Numune Education and Research Hospital, Ophthalmology Clinic, Istanbul, Turkey.
  
  
  METHODS
  Cohort study.
  
  
  METHODS
  Patients with compound myopic astigmatism after DALK and a spherical equivalent (SE) between -2.50 diopters (D) and -8.00 D had LASIK as a single-step procedure, correcting the manifest refraction error. The visual and refractive results at 1 month, 3 months, and the last follow-up were compared with preoperative values.
  
  
  RESULTS
  The mean follow-up was 11.17 months ± 3.61 (SD). The mean manifest refraction SE (MRSE) and autorefractometer measurements and the autokeratorefractometer and corneal topography keratometry readings decreased significantly from preoperatively to 1 month postoperatively (P<.01) but did not change significantly thereafter (P>.05). Preoperatively, the mean uncorrected (UDVA) and corrected (CDVA) distance visual acuities were 0.21 ± 0.08 and 0.73 ± 0.08, respectively; postoperatively, the means were 0.73 ± 0.10 and 0.98 ± 0.05, respectively. All eyes achieved a postoperative UDVA better than 0.5. No eye lost CDVA lines. The safety index was 1.34. The mean MRSE was -5.18 ± 1.74 D preoperatively and -1.05 ± 0.64 D postoperatively (P<.01). Postoperatively, 11 eyes (91.67%) were within ± 2.00 D of the SE, 8 (6.67%) were within ± 1.00 D, and 5 (41.67%) were within ± 0.50 D. No complications were encountered.
  
  
  CONCLUSIONS
  Treatment of post-DALK keratoconus patients with LASIK to correct manifest refraction error seems to be a viable option.
authors.affiliation: Ophthalmology Clinic, Haydarpasa Numune Education and Research Hospital, Istanbul, Turkey. torunbanu@yahoo.com
authors.forename: Banu Torun
authors.initials: BT
authors.lastname: Acar
authors.forename: Canan A
authors.initials: CA
authors.lastname: Utine
authors.forename: Suphi
authors.initials: S
authors.lastname: Acar
authors.forename: Ferda
authors.initials: F
authors.lastname: Ciftci
mesh_terms: D000328:Adult; D001251:Astigmatism / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D015331:Cohort Studies; D019781:Corneal Topography; D016039:Corneal Transplantation; D005260:Female; D006801:Humans; D007640:Keratoconus / Q000601:surgery*; D020731:Keratomileusis, Laser In Situ; D054018:Lasers, Excimer / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D011183:Postoperative Complications; D012029:Refraction, Ocular / Q000502:physiology; D012189:Retrospective Studies; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult