Buzard Kurt, Febbraro Jean-Luc, Fundingsland Bradley R
Department of Surgery, University of Nevada School of Medicine, Las Vegas, NV, USA.
J Cataract Refract Surg. 2004 May;30(5):1006-13. doi: 10.1016/j.jcrs.2003.08.035.
To evaluate the safety, efficacy, and predictability of excimer laser in situ keratomileusis (LASIK) to correct residual myopia and astigmatism after penetrating keratoplasty (PKP).
Buzard Eye Institute, Las Vegas, Nevada, USA.
Twenty-six eyes had LASIK at least 1 year after PKP. All eyes were followed for at least 6 months after LASIK; 22 eyes were followed for 12 months. Sutures were removed at a mean of 13 months post PKP. Laser in situ keratomileusis was performed with the Chiron Automated Corneal Shaper microkeratome (Bausch & Lomb) and the Visx Star excimer laser. Before LASIK, the mean spherical equivalent (SE) was -4.94 diopters (D) +/- 2.79 (SD) and the mean astigmatism was 2.71 +/- 2.33 D; all eyes had regular astigmatism or slightly decentered, irregular astigmatism.
At the last follow-up, the mean postoperative uncorrected visual acuity (UCVA) was 20/30, the mean SE was -0.35 +/- 0.65 D, and the mean residual astigmatism was 1.06 +/- 0.67 D. Eighty-six percent of patients had an SE within +/-1.00 D of emmetropia and a UCVA of 20/40 or better. Ten eyes (39%) had 1 or more enhancements, which were performed a mean of 6 months after the primary LASIK. Significant complications such as wound dehiscence, epithelial ingrowth, and corneal decompensation did not occur. At the last follow-up, 18% of patients lost 1 line of best corrected visual acuity and 27% gained 1 line.
Laser in situ keratomileusis appeared to be a reliable and safe procedure to correct residual myopia and astigmatism after PKP.
评估准分子激光原位角膜磨镶术（LASIK）矫正穿透性角膜移植术（PKP）后残余近视和散光的安全性、有效性及可预测性。
美国内华达州拉斯维加斯的布扎德眼科研究所。
26只眼在PKP至少1年后接受了LASIK。所有眼在LASIK后至少随访6个月；22只眼随访12个月。PKP后平均13个月拆除缝线。使用Chiron自动角膜板层刀（博士伦）和威视准分子激光进行LASIK手术。LASIK术前，平均等效球镜度（SE）为-4.94屈光度（D）±2.79（标准差），平均散光为2.71±2.33 D；所有眼均为规则散光或轻度偏心、不规则散光。
在最后一次随访时，术后平均裸眼视力（UCVA）为20/30，平均SE为-0.35±0.65 D，平均残余散光为1.06±0.67 D。86%的患者SE在正视眼±1.00 D范围内，UCVA为20/40或更好。10只眼（39%）进行了1次或更多次增效手术，平均在初次LASIK术后6个月进行。未发生诸如伤口裂开、上皮内生和角膜失代偿等严重并发症。在最后一次随访时，18%的患者最佳矫正视力下降1行，27%的患者提高1行。
准分子激光原位角膜磨镶术似乎是矫正PKP后残余近视和散光的一种可靠且安全的手术方法。
