Laser-Assisted In Situ Keratomileusis or Photorefractive Keratectomy After Descemet Stripping Automated Endothelial Keratoplasty

Abstract

Purpose: To report the outcomes of laser-assisted in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK) after Descemet stripping automated endothelial keratoplasty (DSAEK). Methods: A retrospective case series was conducted on 5 postoperative unilateral DSAEK cases that underwent LASIK or PRK. DSAEK was performed for Fuchs corneal dystrophy and pseudophakic bullous keratopathy. Postoperative uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), and current graft status were ascertained for the 5 eyes included in the study. Results: All eyes had clear grafts at the most recent postoperative visit. Three eyes underwent LASIK, and 2 eyes had PRK 11 to 17 months after DSAEK. UCVA ranged from 20/80 to 20/200 before refractive surgery (BSCVA: 20/20 to 20/30). Postoperative UCVA improved to 20/20-20/40, and BSCVA was unchanged at 20/20 to 20/30. No patient lost vision. Conclusions: Refractive error after DSAEK may be safely treated with LASIK or PRK. PRK is equally as effective as LASIK. All grafts remain clear, and all the eyes have significantly improved UCVA.