Refractive surgery after Descemet's stripping endothelial keratoplasty

Abstract

To obtain maximum visual rehabilitation, patients undergoing DSEK may require further refractive surgeries. Cataract extraction, LASIK, PRK, PTK, and various combination procedures have been shown to optimize corneal clarity and visual acuity in patients who previously had successful DSEK with subsequent refractive errors. Technological advancements and continued research are necessary to perfect optimal timing and outcomes of these secondary refractive surgeries.

Refractive surgery following corneal graft

“…One of the advantages of the excimer laser, in general, is the ability to treat the wide range of postkeratoplasty refractive errors, including the irregular ones [6,36,37]. Another unique advantage is the ability to remove visually significant subepithelial fibrosis and scarring 'phototherapeutic keratectomy (PTK)' [38]. The addition of mitomycin C to PRK has improved the corneal haze that may happen after conventional PRK (Fig.…”

Advantages of Surface Ablation in Excimer Laser Surgery

“…IOLs: Enhancement by surface laser surgery is best suited than Lasik; since the suction ring is best to be avoided to prevent phakic IOL displacement in an otherwise fragile eye. i-Following descent membrane keratoplasty [12]: PRK can be very helpful to correct either induced or pre-existing refractive errors in patients operated for Descmet membrane keratoplasty. j-"Borderline" cornea: PRK is safer in the thin cornea with normal topography than if operated by Lasik [13]; And in some cases of the cornea with suspicious topography, PRK coupled with corneal cross-linking could be used.…”