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KR Kenyon, F Schirra, NA Afshari; LASIK Following Other Corneal Surgeries: PK, RK, and PRK . Invest. Ophthalmol. Vis. Sci. 2002;43(13):4161.
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Purpose: The purpose of this study is to evaluate the results and complications of laser in situ keratomileusis (LASIK) performed following other corneal surgeries for correction of residual refractive error. Methods: Retrospective analysis of the charts of patients who had undergone LASIK following penetrating keratoplasty (PK), radial keratotomy (RK) or photorefractive keratectomy (PRK) since 1998 was performed. All of the identified patients were included. The relevant information was extracted and the resulting data base was analyzed. Results: Forty eyes of thirty-one patients underwent LASIK for refractive errors following PK (n=9), RK (n=20), and PRK (n=11). Mean preoperative absolute spherical equivalent (SE) refractive error was 2.91 D + 2.56 [SD]. The mean absolute SE for the PK group was 6.40 D + 2.92, for the RK group was 2.013 D + 1.45, and for the PRK group was 1.67 D + 0.742. Mean astigmatism preoperatively in the PK group was 4.86 with a range of 2.75 to 6.50 D. Follow up ranged from 1 day to 22 months after LASIK. At the most recent follow up mean absolute SE refraction was 1.07 D + 0.83. At one month 70% of the eyes were within + 1.00 D of emmetropia and after one year 92% of patients had an uncorrected visual acuity of 20/40 or better. Complications included: keratoplasty wound dehiscence (n=1), corneal flap dislocation (n=1) and epithelialization of RK incisions (n=1). No PK rejection or failure, no infectious or interstitial keratitis were encountered. Conclusion: LASIK affords an effective means for treatment of myopia, astigmatism, and hyperopia in patients with residual refractive errors following PK, RK, and PRK. While the visual results are satisfactory, special attention must be given to this diverse group of patients to prevent significant complications.
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