Laser in situ keratomileusis to correct post-keratoplasty astigmatism; 1-step versus 2-step procedure

J Cataract Refract Surg. 2004 Nov;30(11):2303-10. doi: 10.1016/j.jcrs.2004.04.048.


Purpose: To investigate the correction of post-penetrating keratoplasty (PKP) astigmatism using laser in situ keratomileusis (LASIK). Visual and refractive outcomes were evaluated after LASIK was performed in 1 step (lamellar cut and ablation in 1 procedure) or 2 steps (lamellar cut then ablation in 2 successive procedures).

Setting: Department of Cornea and Refractive Surgery, Vissum-Instituto Oftalmológico de Alicante, University of Miguel Hernández, Alicante, Spain.

Methods: In this prospective observational study, 22 consecutive eyes were divided into 2 groups depending on the LASIK procedure performed to correct post-PKP astigmatism. Group 1 (1-step LASIK) included 11 eyes and Group 2 (2-step LASIK), 11 eyes. The patients were followed for 6 months.

Results: A statistically significant improvement was obtained in Group 2 with a mean vector analysis result of the cylinder of -4.37 diopters (D) +/- 1.79 (SD) (P = .018). In Group 1, the mean astigmatism correction was 2.38 +/- 1.71 D. The number of reoperations and residual refractive defects were significantly better in Group 2.

Conclusion: The 2-step technique improved the accuracy of excimer laser correction of post-PKP astigmatism.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Astigmatism / etiology
  • Astigmatism / surgery*
  • Corneal Topography
  • Female
  • Graft Survival
  • Humans
  • Keratomileusis, Laser In Situ / methods*
  • Keratoplasty, Penetrating / adverse effects*
  • Male
  • Middle Aged
  • Postoperative Complications*
  • Prospective Studies
  • Refraction, Ocular / physiology
  • Safety
  • Treatment Outcome
  • Visual Acuity / physiology