Laser in situ keratomileusis for correction of myopia and astigmatism after penetrating keratoplasty

Ophthalmology. 1999 Oct;106(10):1966-74; discussion 1974-5. doi: 10.1016/S0161-6420(99)90410-4.


Purpose: To determine the safety and effectiveness of laser in situ keratomileusis (LASIK) for visual rehabilitation of residual myopia and astigmatism after penetrating keratoplasty.

Design: Prospective, noncomparative case series.

Participants: LASIK was performed on 23 eyes of 22 patients unable to wear glasses or contact lenses after penetrating keratoplasty due to anisometropia, high astigmatism, and/or contact lens-intolerance.

Methods: All patients underwent LASIK for visual rehabilitation after penetrating keratoplasty. Uncorrected visual acuity and best spectacle-corrected visual acuity, degree of anisometropia, and corneal transplant integrity were recorded before surgery, as well as at 1 month, 3 months, 6 months, and 12 months after LASIK surgery.

Results: The mean spherical equivalent before surgery was -7.58+/-4.42 diopters (D), which was reduced to -1.09+/-2.01 D, -0.79+/-1.84 D, -0.77+/-1.25 D, and -1.57+/-1.20 D, respectively, at 1, 3, 6, and 12 months after LASIK. The mean cylinder before surgery was 3.64+/-1.72 D, which was reduced to 1.98+/-1.15 D, 1.64+/-1.14 D, 1.48+/-0.92 D, and 1.29+/-1.04 D, respectively, at 1, 3, 6, and 12 months after LASIK. Spherical equivalent anisometropia was reduced from a mean of 6.88+/-4.4 D to 1.42+/-1.05 D at the final examination. Best-corrected visual acuity remained the same or improved in 21 of 23 eyes and decreased by 1 and 3 lines in 2 patients. There were no surgical flap or corneal transplant complications.

Conclusions: LASIK is a viable treatment alternative for myopia and astigmatism after penetrating keratoplasty in patients who are contact lens-intolerant. LASIK is more effective in treating myopia than astigmatism after penetrating keratoplasty.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Astigmatism / etiology
  • Astigmatism / surgery*
  • Cell Count
  • Cornea / surgery*
  • Corneal Topography
  • Corneal Transplantation / methods
  • Endothelium, Corneal / cytology
  • Female
  • Humans
  • Keratoplasty, Penetrating / adverse effects*
  • Laser Therapy*
  • Male
  • Middle Aged
  • Myopia / etiology
  • Myopia / surgery*
  • Prospective Studies
  • Refraction, Ocular
  • Surgical Flaps
  • Visual Acuity