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Standardized arcuate keratotomy for postkeratoplasty astigmatism
Mark R Wilkins1, Jod S Mehta, D Frank P Larkin
1Cornea & External Diseases Service, Moorfields Eye Hospital, London, United Kingdom. mail@markwilkins.co.uk
Journal of Cataract and Refractive Surgery
|March 16, 2005
Summary
Standardized arcuate keratotomy (AK) effectively reduced astigmatism in postkeratoplasty eyes. The induced astigmatic change was proportional to the initial astigmatism magnitude, indicating nomograms for congenital astigmatism are unsuitable.
Area of Science:
- Ophthalmology
- Corneal Surgery
- Refractive Surgery
Background:
- Postkeratoplasty astigmatism is a common complication after corneal transplantation.
- Accurate correction of astigmatism is crucial for visual rehabilitation following keratoplasty.
Purpose of the Study:
- To evaluate the efficacy of standardized, paired arcuate keratotomy (AK) in correcting astigmatism in eyes that have undergone corneal transplantation.
- To determine the relationship between preoperative astigmatism and the induced refractive change after AK.
Main Methods:
- Retrospective review of 20 eyes from 19 patients who underwent standardized AK.
- Incision parameters: 60-degree arc length, 600 µm depth, 6.0 mm spacing.
- Analysis of preoperative and postoperative refractions, astigmatic change (surgically induced refractive change), and complications.
Main Results:
- Mean cylinder reduced significantly from -10.99 D to -3.33 D.
- Strong correlation (R² = 0.76) between preoperative cylinder magnitude and induced astigmatic change.
- No significant change in mean spherical equivalent; minor axis deviation in 3 eyes.
Conclusions:
- Standardized AK effectively reduces astigmatism in postkeratoplasty eyes.
- The magnitude of astigmatic correction is proportional to the preoperative astigmatism.
- Existing arcuate nomograms for congenital astigmatism are not applicable for postkeratoplasty eyes.