Correction of Post Keratoplasty Refractive Error by Two Step Femto-LASIK Approach

Background: Vision rehabilitation following a successful keratoplasty remains difficult. Occasionally, Post Keratoplasty Refractive Error cannot be corrected with eyeglasses or contact lenses. In such situations, refractive surgery may be the answer. It has been demonstrated that Femto-LASIK is a safe and effective procedure for reducing postoperative refractive error in keratoplasty patients. Aim: To assess the visual and refractive effect of using two step Femto-LASIK approach for correction of post keratoplasty refractive error. Methods: Prospective interventional study involved 12 patients with high refractive error after keratoplasty that a Two-step Femto-LASIK procedure was performed on after corrective lenses (contacts or glasses) failed to provide acceptable vision correction. Before and after surgery, every patient underwent a thorough ophthalmologic evaluation that included measurements of uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), manifest refraction, corneal topography, tomography, and pachymetry. Results: All eyes showed a big difference in refraction after creation of flap (1st stage), the manifest cylinder had changed as a minimum 3 degree and manifest sphere had changed from 1 3 degree. All eyes showed improvement in UCVA, BCVA and refraction after the 2nd stage. Mean UCVA improved significantly from 0.08 +0.02 prior to operation to 0.57+0.19 LogMar following operation (p