Intraoperative biometry proved to have good predictability for the absolute postoperative refractive error in cataract surgery for eyes at the time of silicone oil removal. This predictability was accurate independent of axial length.

PURPOSE: To evaluate the outcome of phototherapeutic keratectomy (PTK) in the management of recurrent corneal erosions, refractory to other forms of treatment. METHODS: Phototherapeutic keratectomy was performed on 43 eyes of 41 patients with recurrent corneal erosions. The corneal epithelium was debrided, and laser ablation was performed to a depth of 6 µm with an ablation zone of 7 to 9 mm, using the Technolas Keracor 117C PlanoScan excimer laser. Follow-up time was 12 to 48 months (mean, 23.3 ±9.1 mo). RESULTS: After PTK, patients were free of symptoms in 31 eyes (72.1%), and eight eyes (18.6%) had occasional mild symptoms of irritation and photophobia upon awakening. Recurrence of painful corneal erosions occurred in four eyes (9.3%). After PTK retreatment, these patients did not report any further episodes and were free of symptoms for 12 to 30 months (mean, 21.0 ± 7.7 mo). The mean spherical equivalent manifest refraction was changed by +0.15 ± 0.39 D in the hyperopic direction at 1 year after PTK. Thirty-three eyes (76.7%) were within ±1 line of preoperative best spectacle-corrected visual acuity (BSCVA). BSCVA was improved by two or more lines in 10 eyes (23.3%). There were no significant complications. CONCLUSION: Excimer laser PTK with the Technolas Keracor 117C excimer laser was a safe and effective procedure for the treatment of recurrent corneal erosions. Excimer laser PTK can also be useful in improving the visual acuity in these patients. A small percentage of patients may require a second PTK to prevent further episodes of corneal erosions. [J Refract Surg 2000; 17: 511-518]

PURPOSE: To evaluate changes in intraocular pressure (IOP) measurements by Goldmann applanation tonometry after laser in situ keratomileusis (LASIK) for myopia and myopic astigmatism, and to assess the accuracy of Goldmann applanation tonometry measurements after LASIK in these eyes. METHODS: LASIK was performed on 166 eyes of 93 patients for correction of myopia and myopic astigmatism. Intraocular pressure was measured by Goldmann applanation tonometry at the central and temporal parts of the cornea before and at 1, 3, 6, and 12 months after LASIK. The amount of change in IOP was computed and its relation to different variables was evaluated by regression analysis. RESULTS: Intraocular pressure measured at the center of the cornea was reduced by a mean of 3.69 ± 1.63 mmHg after LASIK Multiple regression analysis showed that the decrease in IOP was related to the preoperative IOP and the change in central corneal thickness after LASHC Measurements of IOP at the temporal part of the cornea were also reduced by a mean of 2.39 ± 1.71 mmHg. There was wide variability in the amount of difference between the temporal and central measurements after LASHi (temporal measurements were higher than central by 0 to +4 mmHg). CONCLUSION: LASIK for myopia produced underestimation of IOP measured by Goldmann applanation tonometry at the central part of the cornea by a mean of 3.69 ?1.63 mmHg. The decrease of IOP was related to preoperative IOP and the change in central corneal thickness after LASHi. Temporal Goldmann applanation tonometry measurements, although decreased after LASHi, were less reliable. [J Refract Surg 2001;17:420-427]

PURPOSE: To assess the efficacy, predictability, stability, and safety of laser in situ keratomileusis (LASIK) in patients with hyperopia and to evaluate the visual and refractive results of the procedure. METHODS: LASIK was performed on 85 eyes of 53 patients for correction of hyperopia, with a preoperative mean manifest spherical equivalent refraction of +3.31 ± 0.69 D (range, +1.25 to +5.00 D) and mean refractive astigmatism of +0.91 ± 1.06 D (range, 0 to +3.00 D). The Carriazo-Barraquer (Moria) manual microkeratome was used to create the corneal flap, and laser ablation was performed using the Technolas Keracor 117C excimer laser with an ablation zone diameter of 6.0 mm and a transition zone diameter to 9.0 mm. Follow-up was 12 months for all patients. RESULTS: Refraction was stable by 3 months after surgery. At 1 year after LASIK, the mean manifest spherical equivalent refraction was +0.43 ± 0.57 D (range, -1.25 to +2.00 D) and refractive astigmatism was reduced to a mean of 0.36 ± 0.30 D (range, 0 to 1.00 D). Fifty-two eyes (61.2%) had a manifest spherical equivalent refraction within ±0.50 D of emmetropia, and 76 eyes (89.4%) were within ±1.00 D. Uncorrected visual acuity was 20/20 in 21 eyes (24.7%) and 20/40 or better in 79 eyes (92.9%). Spectacle-corrected visual acuity was reduced by two lines in one eye (1.2%) and improved by two lines in five eyes (5.9%). There were no significant complications. CONCLUSION: LASIK was an effective, safe, and predictable procedure for the correction of hyperopia up to +5.00 D and hyperopic astigmatism up to +3.00 D with the Technolas Keracor 117C excimer laser. The large size of the corneal flap obtained by the Carriazo-Barraquer (Moria) manual microkeratome facilitated laser ablation entirely in the exposed corneal stromal bed. [J Refract Surg 2001;17:113-122]

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PURPOSE: To evaluate the visual and refractive results of laser in situ keratomileusis (LASIK) retreatment on eyes with residual myopia with or without astigmatism. METHODS: LASIK retreatment was performed on 35 eyes of 23 patients for correction of residual myopia, with or without astigmatism, with a mean manifest spherical equivalent refraction of -2.17 ± 0.82 D (range, -1.00 to -3.87 D) and mean refractive astigmatism of -0.55 ± 0.61 D (range, 0 to -1.75 D). Retreatment was performed 3 to 18 months after primary LASDX (mean, 5.1 ± 2.6 mo). The corneal flap of the previous LASIK was lifted and laser ablation was performed using the ChironTechnolas Keracor 116 excimer laser. Follow-up was 12 months for all eyes. RESULTS: At 1 year after retreatment, manifest spherical equivalent refraction was reduced to a mean -0.23 ± 0.28 D (range, 0 to -0.87 D), and refractive astigmatism was reduced to a mean -0.16 ± 0.25 D (range, 0 to -0.75 D). Thirty-two eyes (91.5%) had a manifest spherical equivalent refraction within ±0.50 D of emmetropia, and 33 eyes (94.3%) had 0 to 0.50 D of refractive astigmatism. Uncorrected visual acuity was 20/20 or better in 11 eyes (31.4%). Spectacle-corrected visual acuity was not reduced in any eye after retreatment. There were no significant complications. CONCLUSION: LASEK retreatment was effective for correction of residual myopia or astigmatism after primary LASDX. Refractive results were predictable with good stability after 3 months. Lifting the flap during LASDX retreatment was relatively easy to perform and did not result in visual morbidity in eyes treated from 3 up to 18 months after primary LASIK. [J Refract Surg 2000;16:170-176]

PURPOSE: To evaluate the safety and efficacy of laser in situ keratomileusis (LASIK) for correction of high astigmatism after penetrating keratoplasty, and to assess the refractive results and predictability of the procedure. METHODS; LAStK was performed on 19 patients (19 eyes) with high astigmatism after penetrating keratoplasty, using the Chiron Automated Corneal Shaper and the Chiron-Technolas Keracor 116 excimer laser. The amount of preoperative refractive astigmatism ranged from 6.50 to 14.50 D (mean, 9.21 ± 1.95 D) and the spherical component of manifest refraction ranged from -7.00 to +1.25 D (mean, -2.14 ± 2.11 D). AU patients completed a minimum follow-up of 12 months. RESULTS: Refraction was stable after 3 months. At 1 year after LASDi, the amount of refractive astigmatism was reduced to a mean of 1.09 ± 0.33 D (range, 0.50 to 1.75 D), with 57.9% of the eyes within ±1.00 D of refractive astigmatism. The mean percent reduction of astigmatism was 87.9 ± 3.7%. The postoperative spherical component of manifest refraction ranged from -1.00 to +1.75 D with a mean of +0.43 ± 0.82 D. vector analysis showed that the mean amount of axis deviation was 1.1 ± 1.3° and the mean percent correction of preoperative astigmatism was 92.6 ± 8.4%. There were no intraoperative complications. Spectacle-corrected visual acuity was not reduced in any eye, and improved by 2 or more lines in 42.1% of eyes after LASDi. CONCLUSION: LASIK with the ChironTechnolas Keracor 116 excimer laser was effective for correction of both astigmatism and myopia after penetrating keratoplasty. The procedure proved to be safe and gave fairly predictable and stable refractive results. [J Refract Surg 2000;16:701-710]