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Long-term results of LASIK after penetrating keratoplasty

Název česky Dlouhodobé výsledky u pacientů po LASIKu po perforující keratoplastice
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RYBÁROVÁ Natália VLKOVÁ Eva

Rok publikování 2019
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Popis Purpose: to study the effectiveness of laser in situ keratomileusis (LASIK) in treatment of postkeratoplasty astigmatism in long term follow-up (7 – 18 years) Setting: Ophthalmology Clinic of University Hospital, Brno, Czech Republic Faculty of Medicine, Masaryk University, Brno, Czech Republic Methods: We performed retrospective noncomparative longitudinal analysis of 25 eyes of 21 patients, who underwent laser in-situ keratomileusis (LASIK) at Eye Clinic, the University Hospital in Brno, Czech Republic between 1. 1. 2000 and 31. 12. 2010 in order to correct high astigmatism and ametropia after penetrating keratoplasty for keratoconus. We evaluated uncorrected and best-corrected visual acuity (UCVA, BCVA) in Snellen lines, topographical and manifest astigmatism (TA, MA), spherical equivalent (SE), endothelial cell count, central corneal thickness in each patient preoperatively, at 6th month and then yearly. Results: The follow-up period was 12,8 ± 3,2 years. BCVA significantly improved from preoperative 0,63 ± 0,27 lines to 0,75 ± 0,28 (p= 0,04) at 6th month and at the final follow up regressed to 0,58 ± 0,29 (p = 0,01). UCVA increased from 0,13 ± 0,09 to 0,48 ± 0,26 (p= 0,00) at 6th month and subsequently regressed to 0,36 ± 0,26 (p= 0,02). TA decreased from 5,30 ± 2,05 D to 3,78 ± 2,03 D (p= 0,00) in 6th month and then significantly worsened to 6,46 ± 2,41 (p= 0,00). Average endothelial cell loss was not significant (p= 0,4483). Conclusions: Six months after LASIK topographical astigmatism significantly decreased and UCVA and BCVA significantly improved. We observed significant regression of TA, BCVA and BCVA in the final follow-up. Follow-up period in this cohort was remarkably long and visual acuity was influenced by different factors such as cataract formation and vitreoretinal diseases, which makes interpretation of the results difficult. Significant regression of the topographical astigmatism began at 6th year after LASIK and indicates, that LASIK after penetrating keratoplasty is effective, but mostly temporarily and another treatment for residual astigmatism will be needed. FINANCIAL DISCLOSURE: None