Corneal topography, arcuate keratotomy, and compression sutures for astigmatism after penetrating keratoplasty

• Published in: Journal of refractive surgery (1995) Vol. 12; no. 2; pp. S306 - S309
• Main Authors: KOFFLER, B. H, SMITH, V. M
• Format: Conference Proceeding Journal Article
• Language: English
• Published: Thorofare, NJ Slack 01.02.1996; SLACK INCORPORATED
• Subjects: Aged; Astigmatism - pathology; Astigmatism - surgery; Biological and medical sciences; Cornea - pathology; Cornea - surgery; Female; Follow-Up Studies; Humans; Keratoplasty, Penetrating; Keratotomy, Radial; Male; Medical sciences; Middle Aged; Postoperative Complications - pathology; Postoperative Complications - surgery; Refraction, Ocular; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the eye and orbit; Sutures; Treatment Outcome; Visual Acuity - physiology; Human; Postoperative; Compression; Cornea; Surgical incision; Vision disorder; Penetrating graft; Eye disease; Treatment; Keratoplasty; Surgery; Topography; Refractive error; Technique; Astigmatism
• ISSN: 1081-597X; 1938-2391
• DOI: 10.3928/1081-597X-19960201-28

Twenty (20) patients with post-penetrating keratoplasty (PKP) (21 eyes) and excessive corneal astigmatism were studied using corneal topography to determine placement of arcuate incisions and compression sutures for astigmatism reduction. Keratoplasty wounds and compression sutures were placed asymmetrically based on corneal topography only. Incisions were at the donor-host junction at a depth of 500 microns. A 56% reduction in corneal astigmatism was accomplished with an average cylinder reduction of 5.3 D. Keratometry readings were reduced in 18 of 20 (90%) of eyes and refractive cylinder was reduced in 15 of 20 (75%) of eyes. Corrected visual acuity improved in 15 of 20 (75%) declined in 15%, and did not change in 10%. Visual acuity can be improved by manipulating the astigmatism after penetrating keratoplasty using corneal topography maps to determine placement of arcuate incisions and compression sutures.