Autologous ipsilateral rotating penetrating keratoplasty

To evaluate visual outcome after autologous ipsilateral rotating penetrating keratoplasty.

The study included nine patients who consecutively underwent autologous ipsilateral rotating penetrating keratoplasty for treatment of traumatic central corneal avascular scars. These patients were compared with 105 patients who consecutively underwent homologous central penetrating keratoplasty in the same study period for treatment of avascular corneal scars extending to the corneal periphery. All operations were performed by the same surgeon. Mean follow-up time for both study groups was 31.27 +/- 21.54 and 32.0 +/- 19.4 months, respectively.

In the autologous rotating keratoplasty group, visual acuity increased significantly (P = 0.03; Wilcoxon test) from 0.13 +/- 0.11 preoperatively to 0.29 +/- 0.16 postoperatively. Refractive astigmatism and keratometric astigmatism, respectively, increased (P = 0.02) from 3.19 +/- 2.53 diopters and 3.20 +/- 2.24 diopters, respectively, preoperatively to 6.9 +/- 1.82 diopters and 9.55 +/- 4.32 diopters, respectively, postoperatively. Comparing the study groups, postoperative visual acuity was significantly lower (P = 0.01), and keratometric astigmatism (P = 0.003) and refractive astigmatism (P = 0.01) were significantly higher in the autologous rotating keratoplasty group than in the control group.

Autologous ipsilateral rotating penetrating keratoplasty compared with homologous central penetrating keratoplasty is associated with a high postoperative refractive and keratometric astigmatism leading to a relatively low postoperative visual acuity. It suggests that, in normal clinical conditions when donor material is available and postoperative follow-up examinations can be performed, homologous central penetrating keratoplasty may be superior to autologous ipsilateral rotating keratoplasty.