We present a case of ocular deviation and diplopia that developed 9 months after monocular excimer laser photorefractive keratectomy. In this case, decompensation occurred because of a breakdown of fusion at distance. We suggest a cover test to assess the presence of significant phorias in all candidates for refractive surgery procedures.
The quantitative measures used in this study are sensitive methods by which irregular astigmatism after keratorefractive procedures can be classified, evaluated, and compared.
Thirteen patients with moderate to large amounts of astigmatism after penetrating keratoplasty underwent one of two 1orm$ of relaxing incision described first by Ruiz. Five patients were treated with the trapezoidal incision paitem and eight patients were treated with the newer rectangular incision pattern, both with variable incision length. The average preoperative astigmatism was 7.03 ± 2.64 with an average reduction in cylinder of 6.12 ± 3.50. Complications included microperforation in five cases due to variable graft/host thickness.
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