Two Step Femto-Lasik Approach For Correction Of Post Keratoplasty Refractive Error
Published 2023 - 41st Congress of the ESCRS
Reference: PP03.08 | DOI: 10.82333/7vj2-f705
Authors: Hazem El-Nashar* 1
1consultant of ophthalmology,The Memorial Institute for Ophthalmic Research ,Giza,Egypt
To assess the visual and refractive outcome of using two step Femto-LASIK approach for correction of post keratoplasty refractive error.
the memorial institute for ophthalmic research (MIOIR)
the International Eye Hospital (IEH)
Prospective interventional study involved 12 eyes of 12 patients with high refractive error after remove the sutures of keratoplasty that could not be adequately corrected by contact lenses or spectacles. Patients with central corneal opacity and very thin cornea less than 450um were excluded. follow up period ranges from 6 m to 1 year.
First step was to create a Femto-Lasik flap. We aimed in this step to cut all the adhesions between anterior corneal surface and stroma which lead to change in the refraction of the patient. The second step was done after topography and refraction become stable, where the elevation of flap is much easier. Apply excimer laser depending on stable new refraction then reposit the flap again.
Regarding visual outcome, all eyes showed a big difference in ref after creation of flap (1st stage), the manifest cylinder had changed at least 3 degree and manifest sphere had changed from 1-3 degree. Also, all eyes showed improvement after the 2nd stage. Mean UCVA improved significantly from 0.08 +0.02 before surgery to 0.57+0.19 LogMar after surgery , BCVA improved significantly from 0.35+0.11 to 0.62+0.18 LogMar , Cylinder improved significantly from 6.81+1.52 to -1.55+0.86 D .
The time needed for topography and refraction to become stable to do second step was 6.81 + 2.35 weeks.
Only one complication was occurred all over study, in which small perforation was occurred in the flap during its elevation and didn't need suturing.
Femto-LASIK is a useful and safe procedure for management of postkeratoplasty refractive error with a significant improvement in the UCVA and BCVA with minimal surgical complications. The Two-step LASIK approach has been shown to get more accurate results than One –step LASIK approach in those patients.