Abstract
Abstract: :
Purpose: To demonstrate if bilateral laser in–situ keratomileusis (LASIK) is a safe and effective procedure for patients with bilateral penetrating keratoplasty (PKP) secondary to keratoconus. Methods: Four patients (eight eyes), with keratoconus, underwent PKP in each eye. After an average PKP follow up of 48 months, (range 19–92 months), each eye underwent one stage LASIK using the Visx Star S3 laser to correct their residual refractive error. We used the cycloplegic refraction as the target for their LASIK surgery. Each patient had his or her eyes done separately 3 weeks apart. Results: Pre–LASIK myopia averaged –4.15 ± 3.2D, ranging from –10.00 to +0.75D. Pre–LASIK astigmatism averaged –3.15 ± 0.88D, ranging from –1.75 to –4.50D. Mean pre–LASIK keratometry was 45.4 ± 3.0, ranging from 45.2 to 50.5. Uncorrected visual acuity pre–LASIK averaged 20/320, ranging from 20/60 to 20/400. Best corrected visual acuity (BCVA) pre–LASIK averaged 20/22, ranging from 20/20 to 20/30. Seven eyes had no complications. One eye had a flap button–hole during LASIK and surgery was aborted. No vision was lost in this eye. Mean follow–up after LASIK in the seven eyes was 6 ± 4.2 months, (range 3–12 months). Mean post–LASIK ametropia in these seven eyes was +0.53 ± 0.7D, ranging from –0.50 to +1.75D. Average post–LASIK astigmatism was –0.5 ± 0.83D, ranging from –2.25 to +0.75D. In the seven treated eyes, uncorrected vision post–LASIK averaged 20/23, ranging from 20/20 to 20/25–2. BCVA post–LASIK averaged 20/21, ranging from 20/20 to 20/25. No lines of visual acuity were lost in any of the eyes. Conclusion: Bilateral non–simultaneous LASIK is safe and effective for patients who have had bilateral PKP. In the absence of any intraoperative complications, bilateral simultaneous LASIK can be considered in patients who have PKP in both of their eyes.
Keywords: refractive surgery: LASIK • keratoconus • cornea: clinical science