Laser in situ keratomileusis for correction of induced astigmatism from cataract surgery.

PURPOSE

To evaluate the efficacy, predictability, stability, and safety of laser in situ keratomileusis (LASIK) to correct residual astigmatism after cataract surgery.

METHODS

LASIK was performed on 20 eyes of 20 patients with refractive myopic or mixed astigmatism (3.00 to 6.00 D) at least 1 year after extracapsular cataract extraction with posterior chamber intraocular lens implantation without complication. Each eye received bitoric LASIK with the Nidek EC-5000 excimer laser and the Automated Corneal Shaper microkeratome.

RESULTS

At 6 months after LASIK, mean refractive cylinder decreased from 4.64+/-0.63 D to 0.44+/-0.24 D (P<.001). Mean percent reduction of astigmatism was 90.4+/-5.0% (range 80% to 100%). Mean spherical equivalent refraction decreased from -2.19+/-0.88 D (range -1.00 to -3.88 D) to -0.32+/-0.34 D (range -1.25 to +0.38 D) (P<.001). Vector analysis showed that the mean amount of axis deviation was 0.7+/-1.2 degrees (range 0 degrees to 4.3 degrees) and the mean percent correction of preoperative astigmatism was 92.1+/-5.9% (range 85.6% to 108%). Eighty-five percent of all eyes had a mean spherical equivalent refraction and mean cylinder within +/-0.50 D of emmetropia. Change in spherical equivalent refraction and cylinder from 2 weeks to 6 months was < or = 0.50 D in 90% (18 eyes) and 95% (19 eyes), respectively. Spectacle-corrected visual acuity was not reduced in any eye. Diffuse lamellar keratitis occurred in three eyes (15%) after LASIK, and were treated successfully with eyedrops.

CONCLUSION

LASIK was an effective, predictable, stable, and safe procedure for correction of residual myopic or mixed astigmatism ranging from 3.00 to 6.00 D with a low spherical component after cataract surgery.