Results of excimer laser penetrating keratoplasty in aphakic eyes

Corneal grafting in aphakic eyes is often challenging. We report about the outcome of excimer laser trephination in aphakic eyes. We examined 17 eyes of 17 patients. Diagnosis in 11 eyes was endothelial decompensation and in six, corneal scars. We performed an excimer laser keratoplasty with intraoperative "Flieringa ring" suturing. Follow-up ranged between 3 and 41 (17.6 +/- 11.7) months. Main outcome measures included: best-corrected visual acuity (BCVA), intraocular pressure (IOP), topographic astigmatism, corneal refractive power (CRP), central corneal thickness (CCT) and endothelial cell density (ECD). Preoperative BCVA was light perception in two eyes, hand motion in seven, finger counting in one eye, under 20/400 in six eyes and 20/200 in one eye. IOP ranged between 4 and 28 (13.6 +/- 5.1) mmHg. Topographic astigmatism ranged from 0.5 to 18.5 (7.0 +/- 6.9) dioptres. CRP was between 38 and 59 (46 +/- 9) dioptres. CCT was between 404 and 1069 (748 +/- 181) mu m. Postoperative BCVA was hand motion in five eyes, under 20/400 in two and ranged between 20/200 and 20/20 in ten eyes. IOP ranged between 10 and 40 (18.3 +/- 8.5) mmHg. Topographic astigmatism ranged from 0.9 to 13 (5.5 +/- 3.2) dioptres. CRP was between 31.9 and 46.7 (42 +/- 4.1) dioptres. CCT was between 349 and 820 (552 +/- 115.57) mu m. ECD was between 592 and 2319 (1674 +/- 553) cells/mm(2). Excimer laser trephination can deliver beneficial visual outcomes in most of the aphakic eyes.