title: Deep anterior lamellar keratoplasty for keratectasia after laser in situ keratomileusis.
abstract: OBJECTIVE
  To assess the efficacy of deep anterior lamellar keratoplasty (DALK) for treating post-LASIK keratectasia.
  
  
  METHODS
  Poostchi Eye Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
  
  
  METHODS
  Retrospective interventional cases series.
  
  
  METHODS
  The same surgeon performed all DALK procedures using the Melles manual technique. The preoperative and postoperative corrected distance visual acuity (CDVA), spherical equivalent (SE) refraction, keratometry (K) readings, and endothelial cell profiles were compared.
  
  
  RESULTS
  The cohort comprised 20 eyes of 18 patients (72% women) with a mean age of 29 years ± 4 (SD). The mean follow-up was 31.8 ± 17.0 months (range 6 to 60 months). The mean Snellen CDVA improved significantly from 20/191 before DALK to 20/23 after DALK (P < .001). The mean of the modulus of SE refraction was 11.9 ± 6.6 diopters (D) and 11.4 ± 4.3 D, respectively (P = .446). The mean K value was 52.2 ± 7.0 D before DALK and 46.0 ± 1.9 D after DALK (P = .001); the mean apical K value, 59.5 ± 5.1 D and 49.9 ± 2.8 D, respectively (P < .001); and the mean keratometric astigmatism, 4.3 ± 2.4 D and 1.9 ± 1.2 D, respectively (P = .003). The endothelial cell profile did not change significantly, and no major complications related to DALK occurred. Twelve eyes had additional refractive procedures to correct residual ametropia.
  
  
  CONCLUSIONS
  Deep anterior lamellar keratoplasty using the Melles manual technique was effective and safe in restoring CDVA in patients with post-LASIK keratectasia; however, high residual ametropia was a common finding.
authors.affiliation: From Poostchi Ophthalmology Research Center (Salouti, Nowroozzadeh, Makateb, Ghoreyshi), Shiraz University of Medical Sciences, and Salouti Eye Research Center (Salouti, Zamani, Ghoreyshi), Salouti Eye Clinic, Shiraz, Iran; the Netherlands Institute for Innovative Ocular Surgery (Melles), Rotterdam, the Netherlands.
authors.forename: Ramin
authors.initials: R
authors.lastname: Salouti
authors.affiliation: From Poostchi Ophthalmology Research Center (Salouti, Nowroozzadeh, Makateb, Ghoreyshi), Shiraz University of Medical Sciences, and Salouti Eye Research Center (Salouti, Zamani, Ghoreyshi), Salouti Eye Clinic, Shiraz, Iran; the Netherlands Institute for Innovative Ocular Surgery (Melles), Rotterdam, the Netherlands.
authors.forename: Mohammad H
authors.initials: MH
authors.lastname: Nowroozzadeh
authors.affiliation: From Poostchi Ophthalmology Research Center (Salouti, Nowroozzadeh, Makateb, Ghoreyshi), Shiraz University of Medical Sciences, and Salouti Eye Research Center (Salouti, Zamani, Ghoreyshi), Salouti Eye Clinic, Shiraz, Iran; the Netherlands Institute for Innovative Ocular Surgery (Melles), Rotterdam, the Netherlands.
authors.forename: Payam
authors.initials: P
authors.lastname: Makateb
authors.affiliation: From Poostchi Ophthalmology Research Center (Salouti, Nowroozzadeh, Makateb, Ghoreyshi), Shiraz University of Medical Sciences, and Salouti Eye Research Center (Salouti, Zamani, Ghoreyshi), Salouti Eye Clinic, Shiraz, Iran; the Netherlands Institute for Innovative Ocular Surgery (Melles), Rotterdam, the Netherlands.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Zamani
authors.affiliation: From Poostchi Ophthalmology Research Center (Salouti, Nowroozzadeh, Makateb, Ghoreyshi), Shiraz University of Medical Sciences, and Salouti Eye Research Center (Salouti, Zamani, Ghoreyshi), Salouti Eye Clinic, Shiraz, Iran; the Netherlands Institute for Innovative Ocular Surgery (Melles), Rotterdam, the Netherlands. Electronic address: ghoreyshimaryam@gmail.com.
authors.forename: Maryam
authors.initials: M
authors.lastname: Ghoreyshi
authors.affiliation: From Poostchi Ophthalmology Research Center (Salouti, Nowroozzadeh, Makateb, Ghoreyshi), Shiraz University of Medical Sciences, and Salouti Eye Research Center (Salouti, Zamani, Ghoreyshi), Salouti Eye Clinic, Shiraz, Iran; the Netherlands Institute for Innovative Ocular Surgery (Melles), Rotterdam, the Netherlands.
authors.forename: Gerrit R J
authors.initials: GR
authors.lastname: Melles
mesh_terms: D000328:Adult; D003315:Cornea / Q000473:pathology; D003316:Corneal Diseases / Q000209:etiology / Q000601:surgery*; D019781:Corneal Topography; D016039:Corneal Transplantation / Q000379:methods*; D004108:Dilatation, Pathologic / Q000209:etiology / Q000601:surgery; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D020731:Keratomileusis, Laser In Situ / Q000379:methods*; D054018:Lasers, Excimer / Q000627:therapeutic use*; D008297:Male; D011183:Postoperative Complications; D012029:Refraction, Ocular / Q000502:physiology; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult