Corneal wavefront-guided customized laser in situ keratomileusis after penetrating keratoplasty.
OBJECTIVE
To assess the efficacy and safety of corneal wavefront-guided custom laser in situ keratomileusis (LASIK) to correct refractive errors and higher-order aberrations (HOAs) after penetrating keratoplasty (PKP).


METHODS
Beyoglu Eye Training and Research Hospital, Istanbul, Turkey.


METHODS
Noncomparative case series.


METHODS
The study comprised consecutive patients who were unable to tolerate spectacles or contact lenses for the correction of anisometropia after PKP and had corneal wavefront-guided custom LASIK. The uncorrected (UDVA) and corrected (CDVA) distance visual acuities, manifest refraction spherical equivalent (MRSE), and corneal HOAs were recorded before and after LASIK.


RESULTS
The study evaluated 11 eyes (10 patients). The mean follow-up after LASIK was 24.3 months ± 11.7 (SD) (range 9 to 36 months). The mean MRSE was -2.97 ± 1.66 diopters (D) (range -0.50 to -5.38 D) preoperatively and -0.88 ± 0.96 D (range -2.75 to 0.5 D) postoperatively. The mean total higher-order root mean square (RMS) was 4.65 ± 1.14 μm (range 2.26 to 5.94 μm) preoperatively and 2.71 ± 1.31 μm (range 1.22 to 5.33 μm) postoperatively. Postoperatively, the UDVA improved in 7 eyes and remained unchanged in 4 eyes. The CDVA improved in all eyes postoperatively even cases in which the attempted astigmatic correction was not totally achieved.


CONCLUSIONS
Corneal wavefront-guided custom LASIK after PKP did not totally correct both refractive errors and HOAs because of the high volume of laser ablation required and inadequate corneal stromal thickness.
From the Eye Clinic (Imamoglu), Haydarpasa Numune Education and Research Hospital, a private practice (Kaya), the Department of Ophthalmology (Oral), Faculty of Medicine, Yeditepe University, and Beyoglu Eye Training and Research Hospital (Perente, Basarir, Yilmaz), Istanbul, Turkey. Electronic address: ophserhat@hotmail.com.
Serhat
S
Imamoglu
From the Eye Clinic (Imamoglu), Haydarpasa Numune Education and Research Hospital, a private practice (Kaya), the Department of Ophthalmology (Oral), Faculty of Medicine, Yeditepe University, and Beyoglu Eye Training and Research Hospital (Perente, Basarir, Yilmaz), Istanbul, Turkey.
Vedat
V
Kaya
From the Eye Clinic (Imamoglu), Haydarpasa Numune Education and Research Hospital, a private practice (Kaya), the Department of Ophthalmology (Oral), Faculty of Medicine, Yeditepe University, and Beyoglu Eye Training and Research Hospital (Perente, Basarir, Yilmaz), Istanbul, Turkey.
Deniz
D
Oral
From the Eye Clinic (Imamoglu), Haydarpasa Numune Education and Research Hospital, a private practice (Kaya), the Department of Ophthalmology (Oral), Faculty of Medicine, Yeditepe University, and Beyoglu Eye Training and Research Hospital (Perente, Basarir, Yilmaz), Istanbul, Turkey.
Irfan
I
Perente
From the Eye Clinic (Imamoglu), Haydarpasa Numune Education and Research Hospital, a private practice (Kaya), the Department of Ophthalmology (Oral), Faculty of Medicine, Yeditepe University, and Beyoglu Eye Training and Research Hospital (Perente, Basarir, Yilmaz), Istanbul, Turkey.
Berna
B
Basarir
From the Eye Clinic (Imamoglu), Haydarpasa Numune Education and Research Hospital, a private practice (Kaya), the Department of Ophthalmology (Oral), Faculty of Medicine, Yeditepe University, and Beyoglu Eye Training and Research Hospital (Perente, Basarir, Yilmaz), Istanbul, Turkey.
Omer Faruk
OF
Yilmaz
D000328:Adult; D001251:Astigmatism / Q000503:physiopathology / Q000601:surgery; D003315:Cornea / Q000503:physiopathology; D019781:Corneal Topography; D057108:Corneal Wavefront Aberration / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007640:Keratoconus / Q000503:physiopathology / Q000601:surgery; D020731:Keratomileusis, Laser In Situ / Q000379:methods*; D015948:Keratoplasty, Penetrating; D054018:Lasers, Excimer / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000503:physiopathology / Q000601:surgery; D011182:Postoperative Care; D012029:Refraction, Ocular / Q000502:physiology; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult