准分子激光原位角膜磨镶术后欠矫的再治疗

对２４例（３６只眼）行准分子激光原位角膜磨镶术（ｅｘｃｉｍｅｒｌａｓｅｒｉｎｓｉｔｕｋｅｒａｔｏｍｉｌｅｕｓｉｓ,ＬＡＳＩＫ）后屈光欠矫的患眼,再行原瓣下准分子激光角膜切削术。其中２只眼在ＬＡＳＩＫ术后１个月内施行,３４只眼在术后３～５个月内施行。３６只眼行ＬＡＳＩＫ前的屈光度数为：－５．００～－１７．８７Ｄ,平均－１０．７５±３．４１Ｄ,ＬＡＳＩＫ后欠矫的度数为：－１．２５～－５．５０Ｄ,平均－３．１２±１．１６Ｄ。再手术后,随诊３～６个月。２６只眼（７２．２％）的裸眼视力达到术前矫正视力,２只眼的裸眼视力较术前矫正视力增加一行,８只眼的矫正视力较术前下降一行。术后角膜瓣平整,角膜界面清晰,因此,ＬＡＳＩＫ后屈光欠矫可于术后３～６个月内于原角膜瓣下的基质层再行准分子激光角膜切削术,手术简便、安全、有效。     

准分子激光二次切削治疗近视性角膜切削术后欠矫

本研究共１５人（２３眼）于准分子激光角膜切削术后因欠矫而实施二次切削。术前平均屈光度为－９．８６Ｄ（－５．００—－２０．００Ｄ），其中２眼为中度近视（－３．２５—－６．００Ｄ），６眼为高度近视（－６．２５—－９．００Ｄ），１５眼为超高度近视（≥－９．２５Ｄ）。准分子激光二次切削采用治疗性角膜切削术（ＰＴＫ）和光学性角膜切削术（ＰＲＫ）相结合的方法。术后６个月随访结果表明：９１％的裸眼视力≥０．５，７０％的裸眼视力≥１．０，７０％的屈光度在±１．００Ｄ，角膜无明显混浊。由此证明：准分子激光二次切削治疗近视性角膜切削术后欠矫及角膜混浊是有效的。     

LASIK治疗高度近视的并发症

本研究主要探讨准分子激光原位角膜磨镶术（ＬＡＳＩＫ）治疗高度近视的并发症。对ＬＡＳＩＫ术后随访半年至一年的病人１０９例（２０３眼）进行分析，其术中并发症：角膜瓣蒂过宽或切开不完整２眼（１％）、角膜瓣切断２眼（１％）、角膜瓣过薄６眼（３％）；术后并发症：角膜瓣细微皱褶４眼（２％）、角膜瓣下混浊３眼（１．５％）、角膜瓣下异物４眼（２％）、角膜瓣下上皮植入５眼（２．５％）、眼底出血６眼（３％）。ＬＡＳＩＫ术后并发症较少，但有些并发症可严重影响视力，应引起重视     

PRK与LASIK治疗PK术后残留近视的临床研究

目的 探讨准分子激光角膜切削术（ＰＲＫ）及准分子激光原位角膜磨镶术（ＬＡＳＩＫ）矫治角膜放射状切开术（ＲＫ）后残留近视的安全性、稳定性和可靠性。方法 采用美国ＣＯＭＰＡＫ－２００型准分子激光治疗仪帮ＳＣＭＤ公司的可调节器气动微型角膜刀,分别对ＲＫ后残留近视的３８眼和９眼行ＰＲＫ和ＬＡＳＩＫ术,并随访半年以上。ＰＲＫ组根据屈光状态分为３组：Ⅰ组〈－３．００Ｄ;Ⅱ组－３．００～５．７５Ｄ,Ⅲ组－６．０     

PRK治疗远视和散光的疗效观察

目的：评价准分子激光角膜切削术（ＰＲＫ）对远视和散光的治疗效果。方法：采用美国ＳＣＡＮ－ １９５型准分子激光系统对２６ 例（４６ 眼） 远视和散光进行治疗,Ⅰ组为＋ ２．００ ～＋ ５．００ＤＳ有２４ 眼,Ⅱ组为＋ ５．２５ ～＋９．００ＤＳ有２２ 眼（ 伴散光的有２５ 眼,为＋１．２５ＤＣ～＋３．００ＤＣ） 。并进行治疗后跟踪观察。结果：术后视力：本组患者术后１ 年裸眼视力≥０．５ 者３５ 眼占７６％ ;≥０．８ 者２９ 眼占６３％ ;≥１ ．０ 者１９ 眼占４１ ％ 。其中伴有散光者２５ 眼经激光切削后,裸眼视力≥０ ．５ 者１６ 眼占６４％ ;≥０．８ 者１０ 眼占４０％ ;≥１ ．０ 者６ 眼占２４％ 。结论：ＰＲＫ治疗轻、中度远视是安全有效并且可行。     

放射状角膜切开术后残余近视眼的准分子激光角膜切削术

目的探讨准分子激光角膜切削术（ＰＲＫ）矫治放射状角膜切开术（ＲＫ）后残余近视眼的安全性与有效性。方法应用ＣＨＩＲＯＮ公司ＴｅｃｈｏｌａｓＫｅｒａｃｏｒｌ１６型准分子激光机对１６例（２１只眼）ＲＫ后残余近视眼施ＰＲＫ，应用计算机辅助的角膜地形图对手术的有效性与安全性作客观评估。结果１６例（２１只眼）经ＰＲＫ后，裸眼视力提高４～１０行（平均７．５行）；等效球镜的屈光度下降２．５０～６．００Ｄ（平均４．７５Ｄ）；所有术眼的角膜地形图提示角膜中央呈规则圆形变扁区，角膜中央３ｍｍ直径的屈光力平均下降４．２５Ｄ。随访期内（１ａ）所有术眼无明显并发症。结论ＰＲＫ是矫治ＲＫ后残余近视眼安全有效的方法     

Lasik治疗近视并发症临床分析

目的 分析Ｌａｓｉｋ术中、术后并发症，探讨其发生原因和预防、处理措施。方法 应用ＳＣＭＤ微型角膜刀和ｓｃｈｗｉｎｄ ｋｅｒｅｔｏｍⅢ型准分子激光机对５５６例病人１０９４眼行Ｌａｓｉｋ手术，术后随访病人并观察其疗效３、６、１２个月。结果 并发症有（１）角膜瓣游离４眼（０．３６％）；（２）角膜瓣形成不全２眼（０．１８％）；（３）角膜层间异物１１眼（１．０％）；（４）屈光过矫３、６、１２个月分别为５６眼     

准分子激光屈光性角膜切削术和激光原位角膜磨镶术治疗中低度近视的对比研究

目的：比较准分子激光屈光性角膜切削术（ＰＲＫ） 和激光原位角膜磨镶术（ＬＡＳＩＫ） 治疗中低度近视的临床效果。方法：中、低度近视４００ 例（７１０ 眼） ,其中ＰＲＫ 组３４３ 眼,平均屈光度－４ ．１８±１．２４Ｄ。ＬＡＳＩＫ 组３６７ 眼,平均屈光度－ ４．７５±１．１０Ｄ。两组均于手术后１、３、６、１２ 个月复查视力、屈光度、角膜地形图及角膜上皮下基质混浊等并发症情况。结果：ＰＲＫ组欠矫＞ －１．００Ｄ者９．０３％ ,ＬＡＳＩＫ组为４ ．８０ ％ （Ｐ＜ ０．０１） 。角膜上皮下或层间混浊（Ｈａｚｅ）发生率：ＰＲＫ组０ 级８６ ．５９％ ,１ 级１１．３７％ ,２ 级２ ．０４％ ,３ 级以上无。ＬＡＳＩＫ组０ 级９５．１０％ ,１ 级２．４５％ ,２ 级以上无。结论：ＬＡＳＩＫ术式较之ＰＲＫ术式具有术后视力恢复快而稳定,用药少,痛苦少,并发症少,欠矫率低等优点,中低度近视治疗应首选ＬＡＳＩＫ方法治疗。     

准分子激光角膜切削术治疗角膜表面镜片术后散光

评价准分子激光角膜切削术治疗角膜表面镜片术后散光的效果。采用Ｃｏｈｅｒｅｎｔ产ＳＣＨＷＩＮＤＫＥＲＡＴＯＭ准分子激光治疗系统对８例１２只眼角膜表面镜片术后散光进行治疗，均为圆锥角膜术后病例，术前柱镜屈光度为－１．７５—－１０．００Ｄ，平均－５．４９Ｄ±３．２１Ｄ。术后随访６—１５月，平均１１．８月，显示裸眼视力均明显提高，矫正视力与术前相比提高者７只眼（５８．３３％）。柱镜平均屈光度由－５．４９Ｄ下降至－２．７７Ｄ，均无明显术后痛疼，术后角膜雾状混浊均不显著。说明准分子激光角膜切削术可有效地治疗角膜表面镜片术后的角膜散光，能显著地提高角膜表面镜片术治疗圆锥角膜的最终效果。     

准分子激光屈光性角膜切削术矫正放射状角膜切开术后残留近视

探讨准分子激光角膜切削术矫正放射状角膜切开术后残留近视的效果及影响因素,方法２９例３０眼ＲＫ术后８个月以上接受ＰＲＫ矫正残留近视,分为中低度近视组和高度近视组,平均随访６．４个月。结果ＰＲＫ术后第１组下降３．３０Ｄ,第２组下降５．２３Ｄ。     

Recurrence of corneal dystrophy after excimer laser phototherapeutic keratectomy.

BACKGROUND: Excimer laser phototherapeutic keratectomy (PTK) can be useful to treat anterior corneal dystrophies both before and after penetrating keratoplasty. OBJECTIVE: To evaluate the recurrence of corneal dystrophies after excimer laser PTK. DESIGN: Retrospective case series. PARTICIPANTS: Fifty excimer laser PTK procedures were performed in 43 eyes of 33 patients with corneal dystrophies. Preoperative diagnoses included Reis-Bücklers dystrophy (13 eyes), granular dystrophy (11 eyes), anterior basement membrane (ABM) dystrophy (11 eyes), lattice dystrophy (7 eyes), and Schnyder crystalline dystrophy (1 eye). INTERVENTION: Two excimer lasers (VISX 20/20 model B and VISX Star) were used to perform all PTKs. MAIN OUTCOME MEASURES: After PTK, patients were followed on a regular basis with measurement of best-corrected visual acuity and biomicroscopic examination. Evidence of recurrent dystrophy was noted according to specific criteria. RESULTS: Follow-up range was from 1.1 to 71.2 months (mean, 19.5 months). Clinically significant recurrent dystrophy occurred in 17 eyes. The ABM dystrophy recurred in the form of recurrent corneal erosions in 5 (42%) of the 12 eyes within 6 to 9 months of PTK. Four of these five eyes had mild erosions, which were treated successfully with topical medications while one eye required an additional PTK for an erosion outside the initial treatment area. Eight (47%) of 17 eyes with Reis-Bücklers dystrophy developed clinically significant recurrence an average of 21.6 months after PTK. Three (23%) of 13 eyes with granular dystrophy were found to have a significant recurrence a mean of 40.3 months after PTK. Only one (14%) of seven eyes with lattice dystrophy developed a significant recurrence at 6 months after PTK. Six eyes with significant recurrence after PTK were retreated successfully with additional PTK. Three eyes later developed recurrence of granular and Reis-Bücklers dystrophy after the second PTK. The probability of recurrence of these dystrophies after PTK was calculated using the Kaplan-Meier survival analysis. CONCLUSION: Phototherapeutic keratectomy can restore and preserve useful visual function for a significant period of time in patients with anterior corneal dystrophies. Even though corneal dystrophies are likely to recur eventually after PTK, successful retreatment with PTK is possible.     

Refractive changes after excimer laser phototherapeutic keratectomy

PURPOSE: To study the visual and refractive changes in patients with superficial corneal opacities after excimer laser phototherapeutic keratectomy (PTK). SETTING: Eye Clinic, Kobe Kaisei Hospital, Kobe, Japan. METHODS: One hundred twelve eyes of 80 patients with superficial corneal opacities had PTK with the Nidek EC-5000 excimer laser system. All patients had routine ophthalmic examinations including uncorrected and Landolt best corrected visual acuity (BCVA) measurements, subjective and objective refractions, keratometry, EyeSys (Premier Laser Systems, Inc.) corneal topography performed before and 1 week and 1, 3, 6, and 12 months after PTK, and pachymetry performed before and 12 months after PTK. The change in refractive status within 12 months of PTK and the relationship between factors such as ablation depth, transition zone (TZ) setting, and use of masking agents and the amount of hyperopic shift were also assessed. RESULTS: The BCVA increased by more than 2 lines in 65.1% of eyes and by 1 line in 24.1%. The BCVA did not change in 12 eyes (10.8%) because of cataract or underlying retinal disease. A mean hyperopic shift of 3.42 +/- 1.15 diopters (D) (range 1.00 to 5.25 D) was seen in all eyes at 12 months. The hyperopic shift peaked 1 month after PTK and tended to decline after that; it stabilized at 12 months. CONCLUSION: Although PTK is a safe and efficient method for the treatment of superficial corneal opacities, induced hyperopia after the procedure remains a major problem. A shallow ablation depth (less than 100 microm), presence of a TZ setting, and use of a masking agent decrease the hyperopic shift significantly.     

Long-term results of phototherapeutic keratectomy with 193-nm excimer laser for macular corneal dystrophy

PURPOSE: To investigate functional and morphologic long-term outcome of phototherapeutic keratectomy (PTK) in macular corneal dystrophy. DESIGN: Retrospective, clinical single-center study. METHODS: Between October 1990 and February 2004, 10 eyes (five oculus dexter, five oculus sinister) of 6 patients (mean age, 23 +/- 8 years [range, 15 to 37 years]) with superficial plaque-like opacities that were caused by macular corneal dystrophy were included. After epithelial debridement and pannus removal, PTK was performed with the 193 nm MEL 60 excimer laser. Intended laser ablation depth varied from 20 to 100 microm; the repetition rate was 20/s or 25/s, and the pulse number was 1774 +/- 502 (range, 976 to 2422). Mean follow-up was 4.5 +/- 3.1 years [maximum, 8.7 years]). Main outcome measures included: uncorrected visual acuity, best corrected visual acuity (BCVA), spherical equivalent, keratometric central power, keratometric astigmatism and regularity (semiquantitative classification of Zeiss keratometry; scale 0 to 3), postoperative "haze," time interval until complete epithelial closure, recurrence rate, and necessity of subsequent penetrating keratoplasty (PK). RESULTS: BCVA increased from 0.3 +/- 0.2 before the operation to 0.6 +/- 0.1 after the operation; the mean spherical equivalent increased from -0.9 +/- 1.1 diopters to -0.4 +/- 1.8 diopters. Mean keratometric central power decreased from 44.5 +/- 0.7 diopters to 42.5 +/- 0.6 diopters. During follow-up, recurrences occurred in nine eyes (90%) after 3.4 +/- 0.4 years. In six eyes, a PK was performed after an average of 5.0 years (range, 3.7 to 6.7 years). None of the transplants had a recurrence during the follow-up period. CONCLUSION: In superficial opacities that are caused by macular corneal dystrophy, PTK can increase BCVA moderately for a limited period of time. Despite possible complications, primary PK still appears to be the definite therapeutic option for patients with macular corneal dystrophy.     

Excimer laser phototherapeutic keratectomy: indications, results and its role in the Indian scenario

PURPOSE: To report indications, technique, and results of excimer phototherapeutic keratectomy (PTK), and describe possible reasons for the small numbers of such procedures performed in a referral institute in India. METHODS: Retrospective review of case records of 10 patients (11 eyes) who underwent excimer PTK at our institute between February 1994 and September 1997. RESULTS: Corneal scars were the most common indication for treatment. Best-corrected visual acuity (BCVA) improved in 6 eyes (mean: 2 lines of Snellen acuity). All eyes had BCVA > or = 6/12 after treatment. None of the patients experienced loss of BCVA after treatment. Unaided visual acuity improved in 3 eyes and decreased in 2 eyes. Change in spherical equivalent refraction > or = 1 diopter occurred in 77.8% of eyes after treatment. Treating central corneal scars resulted in a significant hyperopic shift in refraction. CONCLUSIONS: Excimer PTK is a safe and effective procedure for the treatment of superficial corneal opacities. Post-treatment ametropia may require further correction with optical aids. Inappropriate referrals, deep corneal scars, and cost of the procedure could have contributed to the small numbers of PTK performed at our institute. Improved understanding of procedural strengths and limitations could lead to increased use of this procedure, with satisfying results in selected patients.     

Phototherapeutic keratectomy for Schnyder's crystalline corneal dystrophy

PURPOSE: To describe the treatment of Schnyder's crystalline dystrophy (SCD) with excimer laser phototherapeutic keratectomy (PTK). METHODS: Chart review of three patients (four eyes) with SCD treated with PTK between March 1992 and December 1998. Pre- and posttreatment visual acuity, subjective glare, photophobia, manifest refraction, ultrasound pachymetry, hyperopic shift, and biomicroscopic findings were studied. Brightness acuity testing (BAT) was evaluated in two eyes. RESULTS: Four eyes were treated during the study period. The average best corrected visual acuity (BCVA) improved from 20/175 to 20/40 under bright conditions. All patients reported subjective improvement in glare and photophobia. No visually significant recurrence was observed during the follow-up period which ranged from seven months to three years. The mean spherical equivalent refractive shift was +3.28 diopter (D). One patient developed irregular astigmatism from an eccentric ablation. No vision threatening complications were observed. CONCLUSION: PTK can be effective at improving visual symptoms in patients with SCD. It can be a useful therapeutic alternative to lamellar or penetrating keratoplasty in these patients.     

Visual and symptomatic outcome of excimer phototherapeutic keratectomy (PTK) for corneal dystrophies

PURPOSE: To determine the visual results and outcome of excimer laser phototherapeutic keratectomy (PTK) for corneal dystrophies. METHODS: Twenty-nine eyes of 19 patients who underwent excimer PTK for recurrent erosions and reduced vision due to corneal dystrophies, between February 1996 and July 1999, were reviewed. Data regarding the preoperative and postoperative best-corrected visual acuity (BCVA), change in spherical equivalent (SE), depth of excimer laser ablation, symptomatic relief, and incidence of recurrence were analysed by a retrospective chart review. RESULSTS: The range of follow-up was 12-48 months. Twenty-seven out of 29 eyes (93%) maintained or improved BCVA. All patients (17/17) were free of symptoms of recurrent erosions although two eyes needed repeat treatment to achieve this. In those eyes undergoing PTK for reduced vision, there was a trend towards a hyperopic shift postoperatively but this was not statistically significant. Five eyes showed recurrence of the dystrophy (Reis-Bücklers (one eye), Lattice (two eyes), and Granular (two eyes)) that required repeat treatment. Two of these eyes required a single repeat PTK procedure, and three eyes underwent three repeat treatments. There were no major complications during the follow-up period. CONCLUSIONS: Excimer PTK is a safe and effective procedure for relieving symptoms of recurrent erosions and improving visual acuity in patients with corneal dystrophies. Optimal visual results are achieved when treating more anterior disease. Multiple treatments are possible without significant detrimental effects for those patients with recurrence of their dystrophy.     

Automated superficial lamellar keratectomy augmented by excimer laser masked PTK in the management of severe superficial corneal opacities

AIM: To assess superficial lamellar keratectomy augmented by excimer laser smoothening with sodium hyaluronate 0.25%, for the management of superficial corneal opacities. METHODS: Consecutive procedure performed in 14 eyes (13 patients) with an automated microkeratome and excimer laser phototherapeutic keratectomy (PTK) smoothening using sodium hyaluronate 0.25%. MAIN OUTCOME MEASURES: UCVA, BCVA, pachymetry, degree of haze, ray tracing analysis, and complications. Mean follow up was 12 (SD 1.6) months. RESULTS: Mean preoperative haze from previous corneal refractive surgeries was 3.5 (SD 0.5) (11/14 cases). In one case, opacity was caused by ocular trauma and in two by infectious keratitis. The mean preoperative UCVA was 0.7 logMAR (0.2 (SD 0.13) decimal value). BCVA was 0.4 logMAR (0.4 (SD 0.17) decimal value). Mean preoperative corneal pachymetry was 508 (SD 62.5) micro m and mean opacity depth measured by corneal confocal microscopy was 115.2 (SD 49.4) micro m. At 6 months, 71.4% of the eyes with previous corneal refractive surgery showed grade I haze or less. Mean postoperative corneal pachymetry at 6 months was 352.36 (SD 49.05) micro m. CONCLUSIONS: Automated superficial lamellar keratectomy combined with excimer laser PTK smoothening assisted by sodium hyaluronate 0.25% induces a significant improvement of corneal transparency and visual acuity in cases of corneal opacity caused by previous refractive surgery, ocular trauma, and keratitis.     

Phototherapeutic keratectomy in patients with recurrent corneal epithelial erosions

PURPOSE: To evaluate the outcome of phototherapeutic keratectomy (PTK) in the management of recurrent corneal erosions, refractory to other forms of treatment. METHODS: Phototherapeutic keratectomy was performed on 43 eyes of 41 patients with recurrent corneal erosions. The corneal epithelium was debrided, and laser ablation was performed to a depth of 6 microm with an ablation zone of 7 to 9 mm, using the Technolas Keracor 117C PlanoScan excimer laser. Follow-up time was 12 to 48 months (mean, 23.3+/-9.1 mo). RESULTS: After PTK, patients were free of symptoms in 31 eyes (72.1%), and eight eyes (18.6%) had occasional mild symptoms of irritation and photophobia upon awakening. Recurrence of painful corneal erosions occurred in four eyes (9.3%). After PTK retreatment, these patients did not report any further episodes and were free of symptoms for 12 to 30 months (mean, 21.0+/-7.7 mo). The mean spherical equivalent manifest refraction was changed by +0.15+/-0.39 D in the hyperopic direction at 1 year after PTK. Thirty-three eyes (76.7%) were within +/-1 line of preoperative best spectacle-corrected visual acuity (BSCVA). BSCVA was improved by two or more lines in 10 eyes (23.3%). There were no significant complications. CONCLUSION: Excimer laser PTK with the Technolas Keracor 117C excimer laser was a safe and effective procedure for the treatment of recurrent corneal erosions. Excimer laser PTK can also be useful in improving the visual acuity in these patients. A small percentage of patients may require a second PTK to prevent further episodes of corneal erosions.     

Phototherapeutic keratectomy for BIGH3-linked corneal dystrophy recurring after penetrating keratoplasty

PURPOSE: To determine visual results and report side effects and complications after phototherapeutic keratectomy (PTK) for BIGH3-linked corneal dystrophy recurring after penetrating keratoplasty. DESIGN: Retrospective noncomparative case series. PARTICIPANTS: Forty-two excimer laser PTK procedures were performed in 42 eyes of 29 patients with BIGH3-linked corneal dystrophies. Genetic status of all patients was determined and allowed us to assess an unambiguous diagnosis. Preoperative diagnoses included LCDIIIA/A546T (1 eye), R124 l+DT125-DE126 (4 eyes), GICD/R555W (14 eyes), LCDI/R124C (6 eyes), SGD/R124 l (16 eyes), and CDBII/R555Q (1 eye). INTERVENTION: Two excimer lasers (Summit Excimed UV 200, Summit Technology, Waltham, MA and Nidek EC 5000, Nidek, Inc., Gamagori, Japan) were used to perform all PTKs. Indications for performing PTK after a graft were severe decrease of the best-corrected visual acuity (BCVA) related to recurrent corneal deposits and/or painful recurrent epithelial erosions. MAIN OUTCOME MEASURES: Preoperative and postoperative BCVA were analyzed, significant recurrences after treatment were noted, and postoperative complications were recorded. RESULTS: Mean preoperative BCVA was 0.2 +/- 0.12 in the decimal chart, mean postoperative BCVA was 0.52 +/- 0.16 with a mean follow-up of 3.13 +/- 1.77 years (range, 0.3-6.65 years). Visual acuity was significantly improved after surgery (P < 0.05). The magnitude of the change in visual acuity was dependent on the mutation (P < 0.001). Seven symptomatic recurrences were observed. One regressive graft rejection and 4 cases of severe postoperative haze were observed. No other complications were noted. CONCLUSIONS: PTK is a simple, safe, and efficient technique for the treatment of recurrent corneal dystrophies; in many cases it prevents or delays the major incumbent problems of repeated grafting.     

Impact of phototherapeutic keratectomy on the outcome of subsequent penetrating keratoplasty in patients with stromal corneal dystrophies

PURPOSE: To examine the impact of previous phototherapeutic keratectomy (PTK) on the outcome of subsequent penetrating keratoplasty (PK) in patients with stromal corneal dystrophies. DESIGN: Retrospective, cross-sectional, clinical single-center study. METHODS: Patient Population: Fifteen patients (21 eyes) age 39.9 +/- 11.4 years. Inclusion Criteria: Primary homologous PK performed in phakic patients with granular or macular dystrophy; no use of combined surgical procedures; defined graft size and technique. The study group comprised eight eyes of five patients, PK performed 3.7 +/- 2.3 years after PTK. The control group (no previous PTK) comprised 13 eyes of 10 patients. In both groups, 38% had granular and 62% had macular dystrophy. Intervention Procedures: Phototherapeutic keratectomy was performed using a 193 nm excimer laser. All PKs were also performed using this laser, with trephination using a metal mask. Subjective refractometry (trial lenses), standard keratometry (Zeiss ophthalmometer), and corneal topography (Tomey TMS-1) were performed preoperatively, 6 months after PK, and after first and second suture removal (1.1 +/- 0.2 years; 1.6 +/- 0.2 years). Main Outcome Measures: Keratometric, topographic net astigmatism, and refractive cylinder; keratometric and topographic central power; best-corrected visual acuity (BCVA); surface regularity index (SRI), surface asymmetry index (SAI), potential visual acuity (PVA). RESULTS: Refractive power and astigmatism, BCVA, and PVA values did not differ significantly between the two groups at any time-point; SRI tended to be better in the study group after first suture removal (P =.05). CONCLUSION: Preceding PTK does not appear to impair the outcome of subsequent penetrating keratoplasty in stromal corneal dystrophy patients.