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Treatment of mild to moderate keratoconus with laser in situ keratomileusis.

AbstractPURPOSE:
To evaluate the effectiveness, stability, and complications of laser in situ keratomileusis (LASIK) to treat myopic astigmatism in patients with keratoconus.
SETTING:
Buzard Eye Institute, Las Vegas, Nevada, USA.
METHODS:
This study included 16 eyes of 9 patients who had keratometric and/or clinical evidence of keratoconus. Mean age was 45 years, and refraction was stable for at least 2 years. Two treatment approaches were evaluated.
RESULTS:
Mean preoperative spherical equivalent was -4.23 diopters (D) +/- 2.14 (SD) with a mean steep keratometry of 46.81 +/- 3.07 D. Mean preoperative keratometric cylinder was 3.08 +/- 2.22 D. Mean postoperative keratometric cylinder was 3.00 +/- 4.78 D and mean spherical equivalent, -0.44 +/- 0.86 D. Mean postoperative steep keratometry was 44.12 +/- 7.17 D. Two eyes lost 1 line of best corrected visual acuity (BCVA), 1 eye lost 3 lines, and 2 lost 4 lines. Penetrating keratoplasty (PKP) was scheduled in 3 eyes 1 to 2 years after the primary LASIK.
CONCLUSION:
The initial visual results appear promising; but longer term results revealed regression of the refractive outcome in some cases. Moreover, despite improvement in the postoperative spherical equivalent and uncorrected visual acuity in most cases, the risk of loss of BCVA and the necessity of performing PKP in 3 cases lead us not to consider LASIK as a primary solution for keratoconus.
AuthorsK A Buzard, A Tuengler, J L Febbraro
JournalJournal of cataract and refractive surgery (J Cataract Refract Surg) Vol. 25 Issue 12 Pg. 1600-9 (Dec 1999) ISSN: 0886-3350 [Print] United States
PMID10609203 (Publication Type: Comparative Study, Journal Article)
Topics
  • Adult
  • Aged
  • Cornea (pathology, surgery)
  • Corneal Topography
  • Humans
  • Keratoconus (pathology, surgery)
  • Keratomileusis, Laser In Situ
  • Middle Aged
  • Myopia (pathology, surgery)
  • Refraction, Ocular
  • Treatment Outcome
  • Visual Acuity

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