Abstract
Purpose: :
To assess the outcomes ad safety of laser in situ Keratomileusis (LASIK) performed with a femtosecond laser (Intralase®) after penetrating keratoplasty (PK).
Methods: :
Femtosecond laser assisted corneal flaps were performed in 8 eyes of 7 patients mean age: 37.75yrs ± 16.9SD) to correct a mean refractive error after PK of –6.15 ± 1.58SD (range: –4.60 to –8.75). The interval between LASIK and PK ranged between 18 and 36 months and not less than 6 months from suture removal. Central corneal pachometry ranged between 552 and 617 micron. A 15 kHz Femtosecond Laser (Intralase®) for lamellar cuts and a C 217 Chiron Technolas excimer laser for stromal ablation were used, respectively. Corneal flap diameters ranged between 7.75 and 8.5 mm while flap thickness was 120 micron in all cases. BSCVA was 1 in three cases, 0.6 in three cases, and 0.1 in two cases.
Results: :
Early postoperative mean spherical equivalent disclosed 2,25 D ± 0.65 SD and mean cylinder 5.25 D ± 0.20 SD of the preoperative spherical and cylinder error respectively. All patients experienced improved uncorrected and best corrected visual acuity. No intraoperative and postoperative complication were noted. Flap lifting disclosed not difference from standard LASIK performed with Intralase.
Conclusions: :
Although the number of eyes treated is admittedly small, the use of Intralase® to perform flap cuts in PK seems to be safer than the mechanical microcheratome ones. Usual contraindication encountered with mechanical microcheratome, such as excindingly high or low K readings with increased risk of bottonholes or freecup formation, seems not to be an exclusion criteria as long as femtosecond laser is used.
Keywords: refractive surgery: LASIK • transplantation • visual acuity