RESUMO
To compare the safety, efficacy, predictability, stability and complications of wavefront-guided laser-assisted subepithelial keratectomy ( LASEK ) in low myopia, myopic astigmatism and high myopia correction.METHODS: A retrospective analysis of 416 eyes were assigned to 3 groups:159 eyes with low myopia ( LM) and mean refractive spherical equivalent (MRSE) of-3. 68±1. 33 dioptre ( D ); 161 eyes with myopic astigmatism ( MA ) and MRSE of -5. 99 ± 2. 24D and mean cylinder of 2. 41 ± 1. 07D;and 96 eyes with high myopia (HM) and MRSE of- 7. 41 ± 0. 80D. After an epithelial flap creation, a wavefront-based excimer laser ablation was performed. Safety, efficacy, predictability and stability were evaluated at day 10, 2, 6 and 12mo postoperatively.RESULTS:At 12mo, the MRSE was -0. 36 ± 0. 31D in LM group, 0. 15 ± 0. 41D in MA group and 0. 58 ± 0. 68D in HM group. The uncorrected visual acuity ( UCVA) was 20/20 in 90. 60% of patients in LM group, 78. 90% in MA group and 67% in HM group. Efficacy indices were 0. 98, 1. 04 and 0. 92 in LM, MA and HM groups, respectively. Safety indices were 1. 00, 1. 07 and 1. 05 in LM, MA and HM respectively. Five eyes (3. 1%) in the LM group gained 1 line. Forty-four eyes (27. 3%) in MA gained 1-3 lines and eighteen eyes (19. 2%) of HM group gained 1-2 lines of BSCVA. Only 2 eyes in LM group developed corneal haze. There were not statistically significant differences in efficacy and safety indices amongst three groups.CONCLUSlON:Wavefront-guided LASEK is an effective and safe procedure for the treatment of LM, MA, and HM. although in myopic astigmatism the predictability, efficacy and safety indices had been better.
RESUMO
PURPOSE: To report the occurrence of acute hydrops 52 months after successful deep anterior lamellar keratoplasty (DALK) using the Anwar big-bubble technique in a keratoconic eye. METHODS: A 20-year-old man with a history of bilateral keratoconus who had undergone DALK in his right eye, presented with complaints of sudden visual reduction, photophobia, redness, and pain in the same eye. RESULTS: Review of his clinical course, slit-lamp biomicroscopy, and laboratory evaluation, including ultrasound biomicroscopy, revealed acute hydrops in the graft. He was medicated with hypertonic solutions but because of persistent graft edema and nonattached Descemet membrane, penetrating keratoplasty was performed. Histopathologic examination confirmed the diagnosis. CONCLUSIONS: Similar to penetrating keratoplasty, acute hydrops can occur after DALK using the big-bubble technique in patients with keratoconus.
