Complications of Automated Lamellar Keratectomy

Automated lamellar keratectomy (ALK) is a relatively new and rapidly expanding area of keratorefractive surgery. This procedure is generally reserved for individuals with high myopia. In our experience, ALK has become a widely performed procedure despite a lack of published clinical investigations. Of the studies published, most are confined to animal models and shed little light on the potential complications of this surgical procedure. 1-3 In recent weeks, we have evaluated two patients who underwent ALK for high myopia. Both have had difficulties with monocular diplopia and hazy second images. Report of Cases. Case 1. A 27-year-old white man with a history of high myopia, dense amblyopia in the right eye, and chronic granulomatous disease presented with postbilateral ALK of approximately 2 months' duration. His preoperative refraction was −14.75 +4.25×105 OD, yielding counting fingers, and −9.00 +2.25×088 OS, yielding 20/20 visual acuity. He had been previously informed that his chronic