Gorovoy MD Eye Specialists, Ft. Myers, FL, USA.
Cornea. 2011 Jul;30(7):787-9. doi: 10.1097/ICO.0b013e31820686e3.
To report the outcomes of laser-assisted in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK) after Descemet stripping automated endothelial keratoplasty (DSAEK).
A retrospective case series was conducted on 5 postoperative unilateral DSAEK cases that underwent LASIK or PRK. DSAEK was performed for Fuchs corneal dystrophy and pseudophakic bullous keratopathy. Postoperative uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), and current graft status were ascertained for the 5 eyes included in the study.
All eyes had clear grafts at the most recent postoperative visit. Three eyes underwent LASIK, and 2 eyes had PRK 11 to 17 months after DSAEK. UCVA ranged from 20/80 to 20/200 before refractive surgery (BSCVA: 20/20 to 20/30). Postoperative UCVA improved to 20/20-20/40, and BSCVA was unchanged at 20/20 to 20/30. No patient lost vision.
Refractive error after DSAEK may be safely treated with LASIK or PRK. PRK is equally as effective as LASIK. All grafts remain clear, and all the eyes have significantly improved UCVA.
报告在 Descemet 撕囊自动化角膜内皮移植术（DSAEK）后行激光辅助原位角膜磨镶术（LASIK）和光性角膜切削术（PRK）的结果。
对 5 例接受过 LASIK 或 PRK 的单侧 DSAEK 术后的回顾性病例系列进行了研究。DSAEK 用于治疗 Fuchs 角膜营养不良和假性晶状体囊泡性角膜病变。研究中包括的 5 只眼确定了术后未矫正视力（UCVA）、最佳矫正视力（BSCVA）和当前移植物状态。
所有眼在最近的术后随访时均有清晰的移植物。3 只眼行 LASIK，2 只眼在 DSAEK 后 11 至 17 个月行 PRK。屈光手术前 UCVA 范围为 20/80 至 20/200（BSCVA：20/20 至 20/30）。术后 UCVA 提高至 20/20-20/40，BSCVA 保持不变，为 20/20 至 20/30。没有患者视力丧失。
DSAEK 后的屈光不正可以安全地用 LASIK 或 PRK 治疗。PRK 与 LASIK 同样有效。所有移植物均保持清晰，所有眼的 UCVA 均显著提高。
