Myopic keratomileusis by excimer laser on a lathe.

BACKGROUND We designed an excimer laser keratomileusis delivery system to increase the regularity of the refractive cut surface and allow greater precision in the level and shape of the ablated zone. METHODS A parallel faced corneal disc was produced by microkeratectomy from six human eyes and surgical keratectomy in 12 beagle corneas. A 193-nanometer excimer laser that was used to project an oval beam onto the corneal disc was rotated on a flat surface to ensure overlapping of the ovally ablated areas between pulses. RESULTS Electron microscopy of eye bank lenticules demonstrated a circular smooth regularly concave ablation zone. Histological examination of nine clear corneas confirmed thinning of the stroma without fibroblastic reaction and no epithelial hypertrophy. Mean preoperative corneal power of 43.15 +/- 2.18 decreased postoperatively to 33.61 +/- 2.34. CONCLUSIONS The new technique of excimer laser keratomileusis has the advantage of a cut surface smoother and the clear zone is devoid of the stepwise concavity and irregularity seen in diaphragm based photoablation delivery systems.