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Mikhail Romashko, Gerald W Zaidman; Penetrating Keratoplasty for Post-LASIK Ectasia. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3136. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To present the results of penetrating keratoplasty (PKP) for the treatment of post LASIK (laser in situ keratomileusis) corneal ectasia.
Pre and postoperative data were collected for patients who had been referred to the Cornea Service at the Westchester Medical Center with post-LASIK corneal ectasia. Between 2004 and 2013, five patients underwent penetrating keratoplasty (PKP) because of an inability to tolerate contact lenses or spectacles.
All five patients received their first LASIK treatments between 1999 and 2003. Two of the patients also received enhancement procedures. Average time between the first LASIK treatment and PKP was 7.3 ±4.2 (SD) years (range: 2.9 - 13.6). Maximum keratometry before PKP averaged 56.7 ±4.2 (range: 53.0 - 61.9). Average age at the time of PKP was 46.2 ±5.6 years (range: 37 - 52). Patients were followed for an average of 32 ±37 months after PKP (range: 6 - 96 months). Following PKP, uncorrected visual acuity (UCVA) improved in 4 patients and did not change in 1 patient. UCVA average of all five patients improved from 0.09 ±0.08 before the operation, to 0.29 ±0.21 after surgery (P=0.16). Following PKP, best corrected visual acuity (BCVA) improved in all patients. BCVA average of all five patients improved from 0.34 ±0.40 before the operation, to 0.9 ±0.1 after surgery (P=0.046). The patient who showed no change in UCVA had the shortest length of follow-up in the study at 6 months. After surgery, three out of the five patients had complications. Two patients developed transient stromal rejection episodes. One of these patients had rejection episodes at 12 and 17 months after PKP. The other patient suffered a rejection episode at 7 months after PKP. Both patients were successfully treated using topical and oral steroids. A third patient developed borderline glaucoma, which improved with administration of anti-glaucoma eye drops.
The outcomes of PKP in post-LASIK ectasia have rarely been studied. Our data indicates that PKP is an effective treatment for post LASIK ectasia. Complications such as glaucoma or corneal rejection may occur. Patients must be followed closely for this.
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