Laser in situ keratomileusis after penetrating keratoplasty

J Cataract Refract Surg. 2001 Mar;27(3):374-9. doi: 10.1016/s0886-3350(00)00642-8.


Purpose: To assess the outcomes of laser in situ keratomileusis (LASIK) after penetrating keratoplasty (PKP).

Setting: Hospital de Clínicas de Porto Alegre, Department of Ophthalmology, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.

Methods: Fourteen eyes of 13 patients who had LASIK after PKP were retrospectively reviewed. The interval between LASIK and PKP was at least 1 year, and the follow-up after LASIK was also at least 1 year. All patients had a stable refractive error for a minimum of 6 months after all sutures were removed, regular and symmetric topographic astigmatism, and a minimal ultrasonic central corneal pachymetry of 500 microm. The Chiron Automatic Corneal Shaper and the Meditec Aesculap MEL 60 excimer laser were used.

Results: At 12 months, mean myopia decreased from -5.33 diopters (D) +/- 4.22 (SD) to 0.19 +/- 1.71 D, mean hyperopia decreased from +5.04 +/- 3.32 D to + 0.42 +/- 0.46 D, and mean astigmatism decreased from 5.37 +/- 2.12 D to 2.82 +/- 2.42 D (47.5% of mean percentage reduction). Retreatment was necessary in 42.9% of eyes because of cylindrical undercorrection. Uncorrected visual acuity improved in 11 eyes (78.6%). Best spectacle-corrected visual acuity improved in 6 eyes (42.8%) and was maintained in 4 eyes (28.6%); 5 eyes (35.7%) lost 1 Snellen line. Intraoperative complications included 1 buttonhole flap. Postoperative complications included interface epithelial ingrowth at the periphery (2 eyes) and pseudophakic retinal detachment 2 years after LASIK (1 eye).

Conclusion: Laser in situ keratomileusis after PKP safely and predictably corrected the spherical component of the refraction. However, the predictability of LASIK in correcting post-PKP astigmatism was poor.

MeSH terms

  • Adult
  • Cornea / surgery*
  • Corneal Topography
  • Female
  • Follow-Up Studies
  • Graft Rejection / surgery*
  • Humans
  • Keratoconus / surgery*
  • Keratomileusis, Laser In Situ*
  • Keratoplasty, Penetrating / adverse effects*
  • Male
  • Middle Aged
  • Refractive Errors / etiology
  • Refractive Surgical Procedures*
  • Reoperation
  • Treatment Outcome