Nine-year follow-up of a posterior chamber phakic IOL in one eye and LASIK in the fellow eye of the same patient.

To compare the long-term results (9 years) of LASIK in one eye and phakic intraocular lens (implantable contact lens [ICL]) implantation in the fellow eye of the same patient. A patient with high myopia underwent LASIK with a MEL 60 excimer laser in one eye (spherical equivalent refraction -9.75 diopters [D], 5-mm optical zone with no transition zone) and phakic intraocular lens (STAAR Collamer implantable contact lens [ICL]) implantation (spherical equivalent refraction -9.50 D) in the fellow eye. At 9 years postoperatively, the mean spherical equivalent refraction was -1.00 in the eye with the ICL and -1.75 D in the eye that underwent LASIK. During the first 6 postoperative months in the LASIK eye, refraction regressed, but remained stable during the remainder of follow-up. Uncorrected visual acuity was 20/25 in the eye with the ICL and 20/30 in the LASIK eye, whereas best spectacle-corrected visual acuity was 20/20 in both eyes. Less night vision problems (glare and halos) were experienced in the eye with the ICL compared to the LASIK eye. Although the patient initially preferred the LASIK procedure, at last follow-up 9 years postoperatively, increased overall satisfaction was reported for the eye with the ICL compared to the LASIK eye. Nine years after treatment of high myopia with the ICL and LASIK in the same patient, better quality of vision, stability, and satisfaction score were achieved in the eye with the ICL compared to the eye that had undergone LASIK. No long-term sight-threatening complications were found during followup

Laser in situ keratomileusis for residual hyperopic astigmatism after conductive keratoplasty.

To report a case of laser in situ keratomileusis (LASIK) in a patient with previous conductive keratoplasty. A 48-year-old man underwent conductive keratoplasty for low hyperopic astigmatism (manifest refraction OD: +2.25 -0.50 x 77 degrees; OS: +2.50 -0.50 x 105 degrees). Three months postoperatively, UCVA was 20/25 and BSCVA was 20/20 in both eyes; manifest refraction OD: -0.25 -0.75 x 110 degrees; OS: +0.75 -0.75 x 50 degrees. Sixteen months after the operation, regression of refractive outcome was (manifest) OD: +1.75 -1.25 x 90 degrees; OS: +2.50 -0.50 x 85 degrees; UCVA was 20/40 in the right eye and 20/63 in the left eye and BSCVA was 20/20 in both eyes. LASIK was performed for hyperopic regression in the left eye using an automated microkeratome (Alcon SKBM, 130-microm plate; Aesculap-Meditec MEL 70 excimer laser). LASIK was uneventful and no intraoperative or postoperative complications related to the previous conductive keratoplasty procedure or LASIK were observed. Three months after LASIK and 19 months after the initial conductive keratoplasty, the patient's left eye was emmetropic; UCVA was 20/20(-2), BSCVA was 20/20 and manifest refraction was +0.25 -0.25 x 35 degrees. There was a uniform increase in topographical steepening. Visual acuity, refraction and topographic findings remained unchanged at 6 months. Even though our experience is limited, treatment of hyperopia with LASIK in an eye with refractive regression following previous conductive keratoplasty resulted in a predicted refractive outcome, with no complications, and improvement in visual acuity at 6 months follow-up