Ceratectomia fotorrefrativa associada à ceratotomia lamelar pediculada (LASIK) para correção de miopia e astigmatismo moderados e altos em um serviço universitário

Ceratectomia fotorrefrativa associada à ceratotomia lamelar pediculada (LASIK) para correção de miopia e astigmatismo moderados e altos em um serviço universitário

Autores:

Edson S. Mori,
César K. Suzuki,
Norma Allemann,
Paulo Schor,
Mauro Campos,
Wallace Chamon

ARTIGO ORIGINAL

Arquivos Brasileiros de Oftalmologia

versão impressa ISSN 0004-2749versão On-line ISSN 1678-2925

Arq. Bras. Oftalmol. vol.61 no.5 São Paulo out. 1998

http://dx.doi.org/10.5935/0004-2749.19980031

SUMMARY

Purpose:

To evaluate the clinical results and complications of laser assisted in situ keratomileusis (LASIK) in myopic compound astigmatism, moderate and high myopia at a University center.

Patient and Methods:

Seventy eyes from 54 patients who underwent LASIK from April 1996 to April 1997 were evaluated. The Chiron Corneal Shaper® (an automated microkeratome) was used to perform the in situ keratomi-leusis, followed by a refractive ablation with the Summit Apex Plus® excimer laser (193 nm). On three of the 70 eyes no photoablation was performed due to technical problems during keratomileusis. Sixty of the remaining 67 eyes had afollow-up longer than I month and were evaluated. In 36 eyes (60.0%) the spherical equivalent (SE) was corrected (Group 1), and in 24 eyes (40.0%) astigmatic correction was performed (Group 11).

Results:

Average follow-up was 4.5 months. Average pre operative SE was -10.33 D (± 3.29 D). Average variation between attempted and achieved SE correction in the 1st, 3rd and 6th months was respectively +0.06 D (± 1. 74 D), -0.38 D (± 1.78 D) and 0,58 D (± 1. 75 D). There have been 12 surgical complications, eleven of them related to the microkeratome. Forty-three of 60 eyes (71.7%) did not lose nor gain any line in their best-corrected visual acuity evaluated by the Sneelen acuity chart. Ten eyes (16.7%o) lost two or more lines. Seven eyes (11.7%) gained two or more fines. Twenty-one eyes (35.0%) were hypocorrected by 1.00 D or more. Twenty of these eyes belonged to Group I.

Conclusion:

LASIK is a predictable alternative to correct moderate and high myopia. High incidence of complications might be expected during its learning curve.

Keywords: Myopia; Laser; Keratomileusis

REFERÊNCIAS

1 Hayashi S, Braz A, Vasques M, Plut R, Sartori M, Chamon W, Campos M. Ceratectomia fotorrefrativa com excimer laser de fluoreto de argônio de 193 nm para a correção da miopia: estudo clínico. Arq Bras Oftal 1997;60:147-51.
2 Pallikaris IG, Siganos DS. Excimer laser in situ keratomileusis and photorefractive keratectomy for correction of high myopia. J Refract Corneal Surg 1995; 10:498-510.
3 Snibson GR, Carson CA, Aldred GF, Taylor HR. One-year evaluation of excimer laser photorefractive keratectomy for myopia and myopic astigmatism. Arch Ophthalmol 1995;113:994-1000.
4 Corbett MC, O'Brart DTS, Warburton FG, Marshall J. Biologic and environmental risk factors for regression after photorefractive keratectomy. Ophthalmology 1996;103:1381-91.
5 Pallikaris IG, Papatzanaki ME, Siganos DS, Tsilimbaris MK. A corneal flap technique for laser in situ keratomileusis. Arch Ophthalmol 1991;145:1699-1702.
6 Condon PI, Mulhern M, Fulcher T, Foley-Nolan A, O'keefe M. Laser intrastromal keratomileusis for high myopia and myopic astigmatism. Br J Ophthalmol 1997;81:199-206.
7 Bas AM, Onnis R. Excimer laser in situ keratomileusis for myopia. J Refract Surg 1995;11(suppl): 229-33.
8 Gimbel HV, Basti S, Kaye GB, Ferensowicz M. Experince during the learning curve of laser in situ keratomileusis. J Cataract Refract Surg 1996;22:542-50.
9 Carvalho M, Nascimento E, Chamon W, Allemann N, Campos, M.; Scarpi, MJ. - LASIK na correção da alta miopia. Arq Bra Oftal 1997;60:570-5.