Fine tuning excimer laser correction after intraocular lens implantation and corneal transplantation.

PURPOSE

To conduct an analysis of laser in situ keratomileusis (LASDS) results in patients with artiphakia, after phakic posterior chamber intraocular lens implantation, and after corneal transplantation.

METHODS

We analyzed the results of 57 eyes with an IOL that had LASDi: 22 eyes- artiphakia after ECCE with IOL implantation; 8 eyes had phacoemulsification with IOL implantation; 9 eyesartiphakia after removal of transparent lens with IOL implantation in patients with the high myopia (ß eyes) and high hyperopia (3 eyes); 3 eyes- phakic posterior chamber IOL (2 with hyperopia, 1 with myopia); and 15 eyes after corneal transplantation. LASDS correction was performed not earlier than 6 months after IOL implantation and not earlier than 18 months after corneal transplantation. Follow-up ranged from 6 to 12 months after LASDS using the Nidek EC-5000 excimer laser. A thorough ophthalmic examination preceded and followed laser correction.

RESULTS

Mean deviation from emmetropia before LASDS was 3.50 D (range, -6.00 to +4.00 D), and astigmatism averaged 2.75 D (range, 0 to 5.00 D). Before LASDS, mean uncorrected visual acuity was 0.2 and mean spectacle-corrected visual acuity was 6 (range, 0.4 to 1.0). After LASDS, mean deviation from emmetropia was 0.50 D (range, -1.50 to +0.75 D) and average astigmatism was -0.75 D (range, 0 to 1.50 D). Mean uncorrected visual acuity was 0.7 (range, 0.4 to 1.0).

CONCLUSION

LASIK in patients with artiphakia, phakic posterior chamber intraocular lens implantation, and after corneal transplantation was atraumatic, predictable, and efficient. The best results were seen in patients with a myopic refractive error and myopic astigmatism. For hyperopia, LASDS was our method of choice in eyes with "piggy-back" IOLs. J Refract Surg 2000;16(suppl):S257-S260].