Laser in situ keratomileusis to correct refractive errors after keratoplasty

J Cataract Refract Surg. 1999 Apr;25(4):479-85. doi: 10.1016/s0886-3350(99)80043-1.


Purpose: To assess the safety and effectiveness of excimer laser in situ keratomileusis (LASIK) to correct refractive myopia, astigmatism, or both after keratoplasty.

Setting: Eye Clinic Day Hospital, São Paulo, Brazil.

Methods: Twenty-two eyes that had previously had corneal transplantation were studied. Laser in situ keratomileusis was performed using the Chiron automated microkeratome and the VISX Twenty-Twenty B excimer laser.

Results: Mean follow-up after LASIK was 10.09 months +/- 3.87 (SD). The spherical equivalent refraction dropped from -4.55 +/- 3.66 D before LASIK to -0.67 +/- 1.24 D after surgery. At the last examination, 72.7% of patients had a refractive error within +/- 1.00 D of emmetropia and 54.5% had uncorrected visual acuity of 20/40 or better. Vector analysis of astigmatic correction showed an index of success of 54.0%. Best spectacle-corrected visual acuity was unchanged in 8 cases, improved in 9, and decreased in 5. Significant endothelial cell loss, keratoplasty wound dehiscence, and other serious complications did not develop in any eye.

Conclusion: The correction of refractive error with LASIK in postkeratoplasty patients proved to be safe, effective, and predictable. Further studies with longer follow-up are needed to determine the method's clinical value.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Astigmatism / etiology
  • Astigmatism / surgery*
  • Cornea / surgery*
  • Corneal Diseases / surgery
  • Female
  • Follow-Up Studies
  • Humans
  • Keratoplasty, Penetrating / adverse effects*
  • Laser Therapy*
  • Male
  • Middle Aged
  • Myopia / etiology
  • Myopia / surgery*
  • Prospective Studies
  • Treatment Outcome
  • Visual Acuity