EXCIMER-LASER SURGERY FOR KERATOCONUS

Purpose: To determine whether there is increased risk associated with excimer laser surgery of primary keratoconus. Setting: Department of O phthalmology, County Council Hospital, Ryhov, Jonkoping, Sweden. Metho ds: Twenty-four eyes in 23 patients with keratoconus had photorefracti ve keratectomy (PRK) to reduce the steepness of the cone. A VISX Twent y-Twenty B laser.(193 nm) was used for the treatments. Spherical ablat ions, cylindrical ablations, or both were used. Patients were followed for a mean of 22 months (range 6 to 46 months). Results: Fourteen pat ients (58%) had improved visual acuity. Eleven (46%) could manage with only spectacles, and three (13%) were fitted with contact lenses to g et adequate visual function. All treated corneas healed, and no accele ration of the keratoconus was seen. Conclusion: No increased risk was associated with treating primary keratoconus with excimer laser PRK. W e found that excimer laser surgery can improve vision and the ability to wear contact lenses, and it did not interfere with subsequent corne al transplantation surgery.