Keratomileusis in situ for high myopia.

Abstract:

PURPOSE:To examine the safety and efficacy of myopic keratomileusis in situ (automated lamellar keratoplasty) using an automated microkeratome. SETTING:Jules Stein Eye Institute and the Department of Ophthalmology, UCLA School of Medicine, Los Angeles, California. METHODS:A retrospective study was done on 135 consecutive eyes of 91 patients who had keratomileusis in situ for myopia by one surgeon between October 4, 1993, and February 23, 1995. Mean preoperative myopia was 8.30 +/- 2.50 diopters (D) (range 4.50 to 20.50). Follow-up ranged from 1 (108 eyes) to 6 months (52 eyes). No eye had enhancement surgery before 3 months; eyes were dropped from the study at the time of enhancement. RESULTS:Three months after myopic keratomileusis in situ, the mean difference between attempted and achieved correction was an undercorrection of 0.90 +/- 1.50 D; 32 of 83 eyes were within 1.00 D of attempted correction. Forty eyes were undercorrected by more than 1.00 D, and 11 were overcorrected by more than 1.00 D. Uncorrected visual acuity improved to 20/40 or better in 42 of 83 eyes at 3 months. Best spectacle-corrected visual acuity (BSCVA) declined by two or more lines in 8 of 83 eyes at 3 months and 1 of 52 eyes at 6 months. In eyes with 6 months of follow-up, a mean myopic shift of 0.40 D occurred between 3 and 6 months. Two eyes had clinically significant ingrowth into the interface. The variability in outcome (standard deviation in achieved less attempted correction) at 3 months was 1.70 D in the first 45 cases, 1.20 D in the second 45 cases, and 1.10 D in the last 45 cases. CONCLUSION:Myopic keratomileusis in situ is relatively effective and safe for the correction of high myopia; however, a mild loss of BSCVA is not uncommon in the early postoperative period. Surgeon experience may be important for refractive accuracy.

authors

Manche EE,Maloney RK

doi

10.1016/s0886-3350(96)80145-3

subject

Has Abstract

pub_date

1996-12-01 00:00:00

pages

1443-50

issue

10

eissn

0886-3350

issn

1873-4502

pii

S0886-3350(96)80145-3

journal_volume

22

pub_type

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