Enikeratonlasty

Sterile Excimer Laser Shaped Allograft Corneal Inlay for Hyperopia: One-year Clinical Results in 28 Eyes

Purpose: This study aimed to evaluate the one-year clinical results of an allograft corneal inlay (ACI) implantation in a case series of 28 hyperopic eyes of 16 patients.Methods: Patients with manifest refraction spherical equivalent (MRSE) between +1.00 and +6.00 D and having a cylindrical refraction of less than 1 D were included in this prospective study. The refractive powers of excimer laser-shaped ACIs were determined based on the refractive error of the individual subject's eyes. After the creation of a femtosecond flap, the inlays were centered on the pupillary axis. Visual acuities, refractive results, and other clinical findings were reported for the 6- and 12-month follow-up exams.Results: The mean age of the patients included in the study was 36.2 ± 12.4 years (range 22-65 years). The mean pre-operative MSRE of 3.6 ± 1.51 D decreased to 0.21 ± 0.56 D (P < .001). The uncorrected distance and near visual acuity increased from 0.33 ± 0.22 and 0.17 ± 0.13 to 0.75 ± 0.22 (P < .001) and 0.72 ± 0.19 (P < .001), respectively. The corrected distance visual acuity remained unchanged (pre-OP: 0.79 ± 0.22; post-OP: 0.80 ± 0.21; P = .916), and the corrected near visual acuity increased from 0.78 ± 0.22 to 0.84 ± 0.20 (P = .003). The mean K-value and central corneal thickness increased from 42.57 ± 0.81 D and 557.5 ± 43.0 µm to 44.8 ± 1.4 D (P < .001) and 597.1 ± 58.1 µm (P < .001), respectively. No significant postoperative complications such as diffuse lamellar keratitis, epithelial ingrowth, or decentralization were observed.Conclusion: Excimer laser-shaped ACI offers an alternative treatment modality for patients with hyperopia. Acceptable visual results and similar regression rates were observed with ACI implantation compared with other laser refractive procedures.

LASIK after epikeratophakia

PURPOSE

To present a case of successful laser in situ keratomileusis (LASIK) performed on a patient with residual hyperopic astigmatism and symptomatic anisometropia after previous epikeratoplasty (epikeratophakia).

METHODS

LASIK was used successfully to treat hyperopic astigmatism after regression of epikeratophakia performed 16 years earlier.

RESULTS

Visual acuity improved to 20/30 without correction, and best-corrected visual acuity was 20/25 at the 3-month postoperative visit.

CONCLUSIONS

LASIK can be used successfully as an alternative treatment to correct residual refractive error after epikeratoplasty.