[Penetrating keratoplasty in keratoconus by using the method of intraoperative corneal compression]

The authors suggested the method of intraoperative dot-type keratocompression to localize the zones of ectasia in keratoconus. Corneocompression is made before corneal transplantation under the monitoring of the operation microscope by a special corneocompressor (from the keratoconus top to its periphery). The sagging degree of the examined corneal portion proportionate to its thinning is in the focus of attention. Simultaneously, the ectasia zone is marked by a 1% solution of brilliant green, after which a decision is made on the possibility of its radical incision by trepans of various sizes, ranging from 7.5 to 11 mm. Penetrating keratoplasty was made by using this method in 116 patients (147 eyes) with keratoconus of degrees III-IV according to Amsler. Better refractive results, including a higher visual acuity and a lower degree of postoperative astigmatism in long-term follow-ups ranging from 2 to 12 years, were ensured in the main group (77 patients, 93 eyes) versus the control group (39 patients, 54 eyes). Finally, the authors suggested, on the basis of their own experience, an operational classification of keratoconus.