Long-Term Refractive Results of Elliptical Excimer Laser Penetrating Keratoplasty (EELPK)

Abstract

Purpose: To assess long-term refractive and visual outcome of elliptical excimer laser penetrating keratoplasty (EELPK). Methods: Inclusion criteria (17 eyes): (1) Primary central elliptical excimer laser penetrating keratoplasty in phakic eyes; (2) No other simultaneous procedure except cataract surgery in 6 eyes; (3) Interrupted sutures; (4) Complete sequence of follow-ups before EELPK, with all-sutures-in, with all-sutures-out; (5) No active inflammation at the time of EELPK. Best corrected visual acuity (BCVA), refractive and keratometric astigmatism, topographic surface regularity index (SRI), surface asymmetry index (SAI) were determined in 5.9 ± 3.3 years follow-up. Results: BCVA improved from 0.2 preoperatively to 0.6 after suture removal (p < 0.001). After suture removal, keratometric (4.9D/5.8D, p = 0.01) and refractive cylinder (2.8D/4.4D; p < 0.001) increased, and SRI and SAI decreased significantly (3.0/1.0; 1.9/0.9; p = 0.01) compared to all-suture-in values. Conclusions: EELPK is effective in improving visual acuity. Despite topographic regularization, an increase of refractive more than keratometric astigmatism may occur after suture removal.

KEYWORDS:

• astigmatism
• elliptical shape
• excimer laser
• long-term follow-up
• penetrating keratoplasty