Femtosecond laser in situ keratomileusis after radial keratotomy
Accepted 22 February 2006.
Purpose
To assess the safety, efficacy, and predictability of femtosecond laser in situ keratomileusis (LASIK) in eyes with previous radial keratotomy (RK).
Setting
Hospital Virgen del Consuelo de Valencia, Valencia, and Vissum Instituto Oftalmológico de Alicante, Alicante, Spain.
Methods
This prospective study comprised 11 eyes of 7 patients with residual low myopia after previous RK who had surgery with the IntraLase femtosecond laser (IntraLase Corp.) and the Star 2 excimer laser (Visx, Inc.). Uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), defocus equivalent, refraction, flap thickness, flap diameter, and intraoperative complications were evaluated over a minimum 6-month follow-up.
Results
Although the RK incisions opened in all eyes when the flap was lifted, LASIK was successfully completed in all cases. Mean flap thickness was 119 μm ± 13 (SD). There were no cases of slipped flaps, microstriae, or epithelial ingrowth. Defocus equivalent was reduced from a mean of 2.51 ± 0.62 diopters (D) to 0.52 ± 0.28 D; 7 eyes (63.6%) were within ±0.50 D, and 11 eyes (100%) were within ±1.00 D. All eyes had 20/40 or better UCVA, although 2 eyes (18.1%) lost 1 line of BSCVA.
Conclusions
The femtosecond laser was safely used to create thin LASIK flaps in eyes with previous RK. An increased postoperative inflammatory response may explain the loss of BSCVA in some cases. Efficacy and predictability of the procedure were comparable to those of LASIK after RK with mechanical microkeratomes.
From the Refractive Surgery Department, Hospital NISA Virgen del Consuelo (Muñoz, Albarrán-Diego), Valencia, and the Refractive Surgery Department, Vissum Instituto Oftalmológico de Alicante (Muñoz, Sakla, Pérez-Santonja, Alió), Alicante, Spain
Supported in part by a grant from the Spanish Ministry of Health, Red Temática de, Investigación Cooperativa en Oftalmología (ref C 03/13), Subproyecto Cirugía Refractiva y Calidad Visual.
No author has a financial or proprietary interest in any material or method mentioned.
ABSTRACT