Comparing the Rate of Regression after Conductive Keratoplasty with or without Prior Laser-Assisted in situ Keratomileusis or Photorefractive Keratectomy

Purpose: To assess the regression rate of conductive keratoplasty (CK) in patients with or without previous laser-assisted in situ keratomileusis (LASIK) or photorefractive keratectomy (PRK). Setting: University of Utah, Medical School, John A. Moran Eye Center, Salt Lake City, Utah. Materials and Methods: A retrospective, age-matched chart review identified records of 6 patients who underwent CK after refractive surgery and 12 patients who underwent CK without prior refractive surgery. The main outcome measures were postoperative uncorrected and corrected visual acuities and refraction changes over time. Results: Preoperatively, the mean manifest refraction spherical equivalent (MRSE) of the 15 eyes (12 patients) that underwent CK without refractive surgery was 0.83 diopters (D) and the 7 eyes (6 patients) that underwent CK after refractive surgery had an average MRSE of 0.27 D. Postoperatively, the mean MRSE of the refractive surgery patients was -0.86 D at 6 months, regressing to -0.67 D at 12 months. The postoperative MRSE in the eyes without refractive surgery was -0.58 D. at 6 months, regressing to -0.38 D at 12 months. The rate of regression was linear in both groups, calculated at 0.033 D per month in all patients. Conclusions: Patients with previous LASIK or PRK showed a greater treatment response to CK but regressed at a similar rate as those eyes without prior LASIK or PRK. Overall CK is a safe procedure that inevitably regresses.