Abstract:
Purpose: To demonstrate the main technological approaches and clinical results of excimer laser
correction of induced astigmatism after penetrating keratoplasty.
Methods: The study includes of 6 patients (7 eyes) aged 23 - 35 years, after penetrating
keratoplasty due to keratoconus, with a high degree of postoperative astigmatism and irregularity of
the corneal surface. All patients underwent standard preoperative examination, including
endothelial cells density and topographic analysis of anterior and posterior surface of the cornea
(Tomey TMS 5, Japan). Patients were followed up for two years after keratoplasty. Was performed
one-step LASIK using installation "Microscan Vizum".
Superficial corneal flap from 70 to 100 microns thickness was performed with a microkeratome
ML7 (Med-Logics, USA). Terms of follow-up was between 3 to 10 years after Lasik.
Results: The results show the benefits of refractive excimer laser intervention after penetrating
keratoplasty, confirms the significant topographic improvements of the anterior surface of the
cornea. It was obtained high uncorrected visual acuity after refractive surgery, in comparison with
the preoperative maximal corrected visual acuity. Years of dynamic analysis of corneal topography
indicates a long-term stability of refraction after Lasik.
Conclusion: Analysis of clinical - functional results of the correction of refractive errors by
LASIK, using the "Microscan Vizum" showed high efficacy and safety, as well as high
predictability of excimer laser refractive operations. This technology demonstrates the usefulness
of refractive surgery in patients after penetrating keratoplasty with severe refractive errors
combined with anisometropia, which can significantly improve visual function and efficiency of
spectacle correction, contributing to more successful medical-social and professional rehabilitation.
