Two-step LASIK after penetrating keratoplasty

Area of Science:

• Ophthalmology
• Corneal Surgery
• Refractive Surgery

Background:

• Penetrating keratoplasty (PK) is a corneal transplant procedure.
• Refractive errors can persist or develop after PK, necessitating further visual correction.
• Laser in situ keratomileusis (LASIK) offers a potential solution for refractive errors post-PK.

Purpose of the Study:

• To evaluate refractive changes following lamellar keratotomy (LK).
• To assess the refractive outcome of a two-step LASIK procedure in patients with prior PK.
• To determine the efficacy of LK followed by laser ablation for visual correction post-PK.

Main Methods:

• Retrospective review of eight patients who underwent a two-step LASIK procedure after PK.
• Keratotomies performed using Moria LSK one and Amadeus 2 microkeratomes.
• Laser ablation performed using Schwind Keratome I and Wavelight Allegretto WaveEyeQ excimer lasers.

Main Results:

• Significant improvement in uncorrected visual acuity (UCVA) from 1.0 to 0.4 logMar.
• Median UCVA gain of 7.38 lines; best spectacle-corrected visual acuity remained stable.
• Spherical equivalent decreased from -4.02 D to -1.11 D; manifest astigmatism reduced from -7.27 D to -2.08 D post-LASIK.

Conclusions:

• Lamellar keratotomy induces corneal biomechanical changes.
• A two-step LASIK approach enhances refractive precision and predictability in PK patients.
• This staged procedure is favored for optimizing visual outcomes after corneal transplantation.