Laser in situ keratomileusis to correct post-keratoplasty astigmatism:: 1-step versus 2-step procedure

Purpose: To investigate the correction of post-penetratin g keratoplasty (PKP) astigmatism using laser in situ keratomileusis (LASIK). Visual and refractive outcomes were evaluated after LASIK was performed in 1 step (lamellar cut and ablation in 1 procedure) or 2 steps (lamellar cut then ablation in 2 successive procedures). Setting: Department of Cornea and Refractive Surgery, Vissum-Instituto Oftalmologico de Alicante, University of Miguel Hernandez, Alicante, Spain. Methods: In this prospective observational study, 22 consecutive eyes were divided into 2 groups depending on the LASIK procedure performed to correct post-PKP astigmatism. Group 1 (1-step LASIK) included 11 eyes and Group 2 (2-step LASIK), 11 eyes. The patients were followed for 6 months. Results: A statistically significant improvement was obtained in Group 2 with a mean vector analysis result of the cylinder of -4.37 diopters (D) +/- 1.79 (SD) (P = .018). In Group 1, the mean astigmatism correction was 2.38 +/- 1.71 D. The number of reoperations and residual refractive defects were significantly better in Group 2. Conclusion: The 2-step technique improved the accuracy of excimer laser correction of post-PKP astigmatism. (C) 2004 ASCRS and ESCRS.