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July 1997

Catastrophic Complications of Automated Lamellar Keratoplasty

Author Affiliations

Oklahoma City, Okla

Arch Ophthalmol. 1997;115(7):925-926. doi:10.1001/archopht.1997.01100160095020

Automated lamellar keratoplasty (ALK) and its stepchild, laser in situ keratomileusis (LASIK), are emerging treatments for the correction of myopia and hyperopia. We describe 3 patients with severe complications of ALK and poor visual outcomes.

Report of Cases. 

Case 1.  A 33-year-old man underwent uncomplicated ALK in the left eye for 2.25 diopters (D) of hyperopia. On the first postoperative day, the bandage contact lens was removed and the patient noted a foreign body sensation and decreased vision. He presented to the Dean A. McGee Eye Institute, Oklahoma City, Okla, 2 months later with a refractive error of 16.75 + 1.50×65 and a visual acuity of 20/125 OS. Slit-lamp examination of the left eye revealed an absent corneal cap (Figure 1). The corneal bed was thinned and scarred. The patient declined corneal transplantation.

Case 2.  A 32-year-old woman had refractive findings and a visual acuity of −9.00+2.00×105 and 20/25 OD and

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