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


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


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




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).


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.


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


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.