Laser in situ keratomileusis outcomes following radial keratotomy, astigmatic keratotomy, photorefractive keratectomy, and penetrating keratoplasty

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.