LASIK and arcuate incisions for the treatment of post-penetrating keratoplasty anisometropia and/or astigmatism
Schraepen, P.; Vandorselaer, T.; Trau, R.; Tassignon, M.J.
Bulletin de la Societe Belge d'Ophtalmologie 292: 19-25
2004
ISSN/ISBN: 0081-0746 PMID: 15253486 Document Number: 566724
To study the efficacy of Laser In Situ Keratomileusis (LASIK) and Arcuate Keratotomy (AK) for the treatment of anisometropia and/or astigmatism after Penetrating Keratoplasty (PKP) in an attempt to optimize binocular vision. Correction of post-PKP anisometropia and/or astigmatism was considered only when stable refraction was achieved for at least 6 months. Four eyes were treated for anisometropia and astigmatism using the LASIK technique (IN-PRO Gauss Excimer Laser and SKBM Microkeratome). Five eyes were treated with AK to correct post-PKP astigmatism only. The results were evaluated using the following parameters: uncorrected visual acuity (UCVA), best subjective spectacle correction (BSC-VA), corneal uniformity (CU) index and predictive corneal (PC) acuity from the Holladay Diagnostic Summary (HDS) analysis. Post-PKP anisometropia and astigmatism were treated successfully after primary LASIK in three out of the four cases. One eye needed an additional diode thermal keratoplasty (DTK). Astigmatism post-PKP was treated successfully after primary AK in four of the five cases. One eye needed an additional LASIK. AK can be used successfully in cases of low-grade post-PKP astigmatism. LASIK gives better results in cases of post-PKP anisometropia and astigmatism. In order to affine the final results a combination with other refractive techniques such as DTK can be proposed. CU index and PC acuity (EyeSys-HDS analysis) are poor predictive parameters for visual outcome in cases of irregular corneal surfaces as it is often the case after PKP.