Customized transepithelial photorefractive keratectomy for iatrogenic ametropia after penetrating or deep lamellar keratoplasty

PURPOSE: To evaluate the safety and efficacy of customized transepithelial photorefractive keratectomy (PRK) for the correction of iatrogenic ametropia after penetrating keratoplasty (PKP) or deep lamellar keratoplasty. SETTING: Eye Clinic, Department of Neurological and Visual Sciences, University of Verona, Verona, Italy. METHODS: This study comprised 9 patients who had irregular astigmatism from 2.0 to 8.0 diopters (D) after PKP or deep lamellar keratoplasty. The ametropia was corrected with customized transepithelial PRK and the Corneal Interactive Programmed Topographic Ablation (CIPTA) software program (LIGI). Complete ophthalmic examinations were performed before and after surgery. RESULTS: The mean age of the patients was 39.2 years (range 31 to 59 years). All patients gained at least 2 Snellen lines of uncorrected visual acuity; 2 patients had an increase of at least 5 lines, and 3 patients had an increase of 8 lines. The mean refractive spherical equivalent changed from -2.98 D +/- 3.11 (SD) (range -7.25 to + 3.00 D) before PRK to -0.58 +/- 0.84 D (range 0 to -2.50 D) at the last follow-up visit. One patient presented with grade 1 haze that did not improve with topical steroid therapy. No patient lost best spectacle-corrected visual acuity. CONCLUSION: Customized transepithelial PRK with the CIPTA software was a safe and effective treatment for irregular astigmatism after PKP or deep lamellar keratoplasty.