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Sutureless superficial anterior lamellar keratoplasty for recurrent corneal haze after repeat excimer laser surface ablation
  1. James Myerscough1,
  2. Cristina Bovone2,3,4,
  3. Peter Benjamin Michael Thomas5,
  4. Michael Mimouni6,
  5. Faisal Aljassar7,
  6. Sara Padroni3,
  7. Massimo Busin3,4
  1. 1 Department of Ophthalmology, Southend University Hospital NHS Foundation Trust, Westcliff-on-Sea, UK
  2. 2 Department of Ophthalmology, Ospedale Privato “Villa Igea”, Forli, Italy
  3. 3 Department of Ophthalmology, Leicester Royal Infirmary, Leicester, UK
  4. 4 Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
  5. 5 NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust, London, UK
  6. 6 Department of Ophthalmology, Rambam Health Care Campus and Ruth Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
  7. 7 Department of Ophthalmology, The Eye centre and The Eye Foundation for Research in Ophthalmology, Riyadh, Saudi Arabia
  1. Correspondence to Dr Massimo Busin, Ophthalmology, Villa Igea Hospital, Forli 47122, Italy; mbusin{at}


Background/Aims To evaluate the 5-year outcomes of sutureless superficial anterior lamellar keratoplasty (SALK) in the treatment of surface ablation-related corneal haze recurring after phototherapeutic keratectomy (PTK).

Methods Prospective interventional study at a tertiary referral centre in Forli, Italy. Ten consecutive eyes with corneal haze following photorefractive keratectomy, recurring after treatment with PTK with or without mitomycin C, undergoing sutureless SALK. Sutureless SALK was performed using a microkeratome in donor and recipient. Main outcome measures: best spectacle-corrected visual acuity (BSCVA), surgically induced astigmatism (SIA), rate of recurrence and complications.

Results There were no intraoperative complications and there was no recurrence of haze in any eye postoperatively. BSCVA showed significant improvement at all postoperative time points. Mean preoperative visual acuity improved from 0.46 logMAR units (SD=0.12) to 0.12 (SD=0.12, p=0.0001) at 5 years. At 6 months, SIA was 2.50±1.04 with no further significant change at 5 years (2.53±1.39, p=0.95). There was no significant change in mean spherical equivalent and no significant difference between preoperative and postoperative astigmatism vector values at 5 years.

Conclusions Sutureless SALK provides a useful treatment option in patients with recurrent haze after excimer laser treatment. It can eliminate haze recurrence for at least a period of 5 years and can improve BSCVA, although there may be significant SIA.

  • cornea

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  • Contributors All authors made a substantive contribution to the paper and are in agreement with its contents.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.

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