Excimer laser photorefractive keratectomy for treatment of keratoconus.

Abstract

BACKGROUND Five eyes with keratoconus that were scheduled for penetrating keratoplasty were treated instead with excimer laser photorefractive keratectomy to reduce the steepness of the cone. The follow up after 6 to 12 months is reported here. METHODS A 193-nanometer excimer laser system VISX 20/20 was used for correction of myopia or astigmatism. The patients had a complete ophthalmological examination including slit-lamp microscopy and videokeratography. The patients were followed with six examinations during a period of at least 6 months. RESULTS In four eyes, a reduction of the astigmatism was achieved with an increase of visual acuity. There were no problems with wound healing or any signs that the excimer adversely affected the cornea or activated the keratoconus disease process. CONCLUSION The treatment of keratoconus with excimer laser has been regarded as seriously contraindicated on a speculative basis. This risk seems to be exaggerated.