ABSTRACT
PURPOSE: To evaluate the safety and efficacy of laser in situ keratomileusis (LASIK) to enhance refractive status following other corneal surgical procedures. SETTING: Clinical office-based practice. METHODS: Seventy-one eyes of 57 patients had LASIK for refractive errors following radial keratotomy (n = 22), astigmatic keratotomy (n = 13), photorefractive keratectomy (n = 18), and penetrating keratoplasty (n = 18). A Moria LSK-1 microkeratome was used with a Visx S2 or Wavelight Allegretto excimer laser. Data were acquired by retrospective chart review of all appropriately qualified patients. RESULTS: The mean preoperative manifest refractive spherical equivalent (MRSE) was -3.93 diopters (D) +/- 2.83 (SD) in myopic eyes and +1.43 +/- 1.79 D in hyperopic eyes. The mean time from the initial corneal surgical procedure to LASIK was 65.0 months. The mean post-LASIK follow-up was 9.40 months (range 1 to 42 months). Postoperatively, the mean MRSE was -0.85 +/- 1.42 D in myopic eyes (P<.0001) and -0.16 +/- 1.09 D in hyperopic eyes (P<.0001). Enhancement by LASIK was required in 14% of eyes. CONCLUSION: In eyes that have had a variety of previous corneal surgeries, LASIK offers a safe and predictable method for enhancing refractive results.
Subject(s)
Astigmatism/surgery , Keratomileusis, Laser In Situ/methods , Keratoplasty, Penetrating/adverse effects , Keratotomy, Radial/adverse effects , Photorefractive Keratectomy/adverse effects , Refractive Surgical Procedures , Corneal Diseases/surgery , Humans , Lasers, Excimer , Refractive Errors/etiology , Reoperation , Retrospective Studies , Time Factors , Treatment Outcome , Visual AcuityABSTRACT
Al enfrentar este problema, el médico debe considerar como diagnósticos diferencial la posibilidad de conjuntivitis, iritis, glaucoma agudo, úlcera corneana, queratitis herpética o traumatismo de la cornea. En este artículo se pasa revista a las principales claves diagnósticas y a las bases de la terapéutica de cada una de estas enfermedades.
