Femtosecond Laser-Assisted In Situ Keratomileusis Treatment of Residual Refractive Error following Femtosecond Laser-Enabled Keratoplasty

Abstract

Purpose. To evaluate the safety and effectiveness of femtosecond laser-assisted in situ keratomileusis (LASIK) in the treatment of residual myopia and astigmatism following femtosecond laser-enabled keratoplasty (FLEK). Design. Retrospective case review. Methods. Chart review of all patients with prior FLEK who subsequently underwent femto-LASIK surgery after full suture removal was performed at the Gavin Herbert Eye Institute at the University of California, Irvine. A total of 14 eyes in 13 patients met this criterion, and their comprehensive examinations performed at standard intervals were reviewed. Main outcome measures include uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) expressed as the logarithm of the minimum angle of resolution (logMAR), manifest refractive astigmatism, and spherical equivalent. Results. From the preoperative visit to the 3 month visit, all 14 eyes significantly improved in UDVA (logMAR, 0.93 ± 0.23 to 0.44 ± 0.32, P=0.002) with no loss of CDVA (logMAR, 0.26 ± 0.19 to 0.18 ± 0.23, P=0.50). All 14 eyes showed significant improvement in manifest refractive astigmatism (4.71 ± 1.77 to 2.18 ± 1.45 diopters (D), P=0.003) and spherical equivalent (−2.57 ± 2.45 to −0.48 ± 0.83 D, P=0.0007). There were no flap or graft complications as a result of femto-LASIK. Conclusions. Our findings suggest that femto-LASIK on eyes with prior FLEK is safe and effective in improving visual acuity and reducing residual astigmatism.

Femtosecond Thin-flap laser assisted in situ keratomileusis for Correction of Post- Penetrating Keratoplasty Ametropia: Long-Term Outcome

“…Although complications of Femto-LASIK after PK are relatively rare, they may include corneal perforation and scarring, ap-related issues, epithelial ingrowth, and grafthost junction dehiscence. 15 Our study, like previous studies, 5,6,[13][14][15] shows the safety and e cacy of femto-LASIK in correcting refractive error after PK. (Supplementary table 3) Intraoperatively, there were no complications observed during ap creation and laser ablation.…”

“…In cases with anisometropia or high refractive error, where contact lens wear is not an option, corrective refractive surgery can be considered as a viable means to achieve emmetropia. 15 Numerous studies have investigated the use of an excimer laser for correcting refractive errors following PK. However, outcomes of PRK in post-PK patients are less reliable and less effective, and may result in an increased incidence of irregular astigmatism, signi cant regression, and late corneal haze.…”

SMILE After DALK to Reduce Residual Refraction: Two-Year Results

“…One reason for the lower spherical correction in our study could be the lower preoperative sphere. The mean preoperative sphere was 1.9 D in our study, 5.3 D in the study by Massoud et al (10), 5.1 D in the study by Kovoor et al (17), and 2.6 D in the study by Shen et al (20).…”

SMILE after DALK to reduce residual refraction: two-year results

“…One reason for the lower spherical correction in our study could be the lower preoperative sphere. The mean preoperative sphere was 1.9 D in our study, 5.3 D in the study by Massoud et al (10), 5.1 D in the study by Kovoor et al (17), and 2.6 D in the study by Shen et al (20).…”