Untitled

Abstract

A surgical technique was designed to improve safety pterygium excision with intraoperative application of mitomycin-C (MMC). A limbic incision was performed in 40 eyes. The body of the pterygium was dissected from the episclera to allow its excision. Care was taken to avoid excessive delamination and cauterization of tissues. A 0.02% MMC solution was then applied. Only at the end of the surgery was the head of the pterygium dissected from the cornea. The 8-0 absorbable sutures were used to place both edges of the conjunctiva together to completely cover the area of bare sclera. After a mean followup time of 12 months, a recurrence rate of 5% was observed. No complications of therapy were observed. This is a logical alternative to other surgical techniques. However, randomized studies with more patients and longer follow-up are necessary to determine the potential of this procedure in improving the safety of pterygium excision with intraoperative MMC.Laser in situ keratomileusis to correct refractive errors after keratoplasty Purpose: To assess the safety and effectiveness of excimer laser in situ keratomileusis (LASIK) to correct refractive myopia, astigmatism, or both after keratoplasty.Setting: Eye Clinic Day Hospital, São Paulo, Brazil. Methods: Twenty-two eyes that had previously had corneal transplantation were studies. Laser in situ keratomileusis was performed using the Chiron automated microkeratome and the VISX Twenty-Twenty B excimer laser.Results: Mean follow-up after LASIK was 10.09 months ± 3.87 (SD). The spherical equivalent refraction dropped from -4.55 ± 3.66 D before LASIK to -0.67 ± 1.24 D after surgery. At the last examination, 72.7% of patients had a refractive error within ± 1.00 D of emmetropia and 54.5% had uncorrected visual acuity of 20/40 of better. Vector analysis of astigmatic correction showed an index of success of 54.0%. Best spectacle-corrected visual acuity was unchanged in 8 cases, improved in 9, and decreased in 5. Significant endothelial cell loss, keratoplasty wound dehiscence, and other serious complications did not develop in any eye.Conclusion: The correction of refractive error with LASIK in postkeratoplasty patients proved to be safe, effective, and predictable. Further studies with longer follow-up are needed to determine the method's clinical value.