LASIK effective on ametropia after PK

LASIK is an effective procedure for reducing ametropia in patients who have previously undergone penetrating keratoplasty, according to a study. However, patient counseling is of the upmost importance as the results after LASIK may not be as good had the eye had naturally occurring myopia and astigmatism, the study authors warn.

David R. Hardten, MD, and colleagues retrospectively reviewed 57 eyes of 48 patients with anisometropia or high astigmatism who were spectacle- or lens-intolerant after undergoing PK. All patients underwent LASIK for visual rehabilitation. Follow-up was up to 60 months after the LASIK surgery, with a mean of 21.4 months.

The mean preoperative spherical equivalent was –4.19 D after the penetrating keratoplasty but before LASIK. The mean preop astigmatism was 4.67 D. Preop best corrected visual acuity was 20/40 or better in 42 eyes.

Two years after LASIK, 28 eyes had completed follow-up. In those eyes, the mean spherical equivalent was –0.61 D and mean astigmatism was 1.94 D. Uncorrected visual acuity was 20/40 or better in 12 eyes, and BCVA was 20/40 or better in 24 eyes at the 2 year follow-up point. A one line or more gain in BCVA occurred in eight eyes. Two eyes had a loss of two or more lines of BCVA at 2 years, and nine eyes developed epithelial ingrowth. Five eyes in the case series had repeat corneal transplants.

The study is published in the July issue of Cornea.