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Laser in situ keratomileusis to manage refractive errors after deep anterior lamellar keratoplasty

Laser in situ keratomileusis to manage refractive errors after deep anterior lamellar keratoplasty

Banu Torun Acar, MD, Canan A. Utine, MD, MSc, Suphi Acar, MD, Ferda Ciftci, MD

Purpose

To analyze the visual and refractive outcomes of laser in situ keratomileusis (LASIK) after deep anterior lamellar keratoplasty (DALK) for keratoconus.

Setting

Haydarpasa Numune Education and Research Hospital, Ophthalmology Clinic, Istanbul, Turkey.

Design

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.

Conclusion

Treatment of post-DALK keratoconus patients with LASIK to correct manifest refraction error seems to be a viable option.