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One-step vs two-step FemtoLASIK procedure to manage post-penetrating keratoplasty astigmatism and refractive errors: 3 years follow-up

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Session Details

Session Title: LASIK II

Session Date/Time: Tuesday 08/09/2015 | 14:00-16:00

Paper Time: 14:06

Venue: Room 10

First Author: : L.Mosca ITALY

Co Author(s): :    L. Guccione   L. Salvatore   O. Caporossi   T. Maria Emanuela   C. Aldo        

Abstract Details


To investigate visual and refractive outcomes of post-penetrating keratoplasty astigmatism and refractive errors with femtosecond-assisted LASIK performed in 1 step (lamellar cut and excimer ablation at the same time) or 2 steps (first lamellar cut and then delayed excimer ablation).


Cornea and Refractive Surgery Service, Ophthalmic Department, A. Gemelli Polyclinic, Catholic University of “Sacro Cuore”, Rome, Italy.


In this retrospective non randomized comparative study, 27 eyes of 26 patients (15 male, 11 female; mean age: 41 yrs ± 13.6 SD, range: 23 to 69 years.) underwent to LASIK procedure assisted by a femtosecond laser (Femto-LASIK) to correct high post-PKP refractive errors, at least two years after complete suture removal. Group 1 (one-step Femto-LASIK) included 14 eyes and Group 2 (two-step Femto-LASIK), 13 eyes. The follow-up was 3 years.


The mean refractive spherical equivalent (MRSE) improved from 3.97D ± 2.34SD to 0.91D ± 1.65SD in Group 1 and from 5.22D ± 2.47SD to 1.46D ± 1.43SD in Group 2. A statistical significant improvement in refractive cylinder was obtained in both groups, but it was a little more evident in Group 2 (60% vs 65% of preoperative values). Best spectacle-corrected visual acuity improved in both groups (BSCVA Group 1: from 1.42 logMAR ± 0.56SD to 0.07 logMAR ± 0.25SD; BSCVA Group 2: 1.28 logMAR ± 0.63SD to 0.05 logMAR± 0.27SD).


Femtolaser-assisted LASIK, performed in one or two steps, is a reasonably safe and predictable procedure in reducing high refractive errors in post-PKP corneas, with acceptable stability over time. Visual and refractive outcomes were found to be a little better in the two-step technique.

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