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Published on: July 6, 2015
Corneal wavefront-guided customized laser in situ keratomileusis after penetrating keratoplasty
Serhat Imamoglu1, Vedat Kaya1, Deniz Oral1
1From 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.
Purpose:
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).
Setting:
Beyoglu Eye Training and Research Hospital, Istanbul, Turkey.
Design:
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.
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