Laser in situ keratomileusis to correct refractive errors after keratoplasty

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 werestudied. 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 sphericalequivalent 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.