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Correction of Presbyopia by Monocular Bi-Aspheric Ablation Profile
05:46

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Published on: September 20, 2024

Refractive surgery after corneal transplant.

Jocelyn Kuryan1, Prabjot Channa

  • 1Department of Ophthalmology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York 10467, USA.

Current Opinion in Ophthalmology
|May 15, 2010
PubMed
Summary

Refractive surgery effectively corrects vision problems after corneal transplants, improving visual outcomes for patients intolerant of glasses or contacts. Advances offer more options for enhanced post-keratoplasty vision quality.

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Area of Science:

  • Ophthalmology
  • Corneal Surgery
  • Refractive Surgery

Background:

  • Ametropia and astigmatism are common after corneal transplantation (penetrating keratoplasty, ALK, DSEK), impacting vision quality.
  • Patients may experience aniseikonia and intolerance to spectacles or contact lenses post-keratoplasty.
  • Existing refractive errors can significantly diminish the benefits of a successful corneal transplant.

Purpose of the Study:

  • To review refractive surgery options for correcting ametropia and astigmatism after corneal transplantation.
  • To assess the efficacy of various refractive techniques in improving visual outcomes in post-keratoplasty patients.
  • To highlight the potential of refractive surgery to enhance quality of vision for transplant recipients.

Main Methods:

  • Review of current literature on refractive surgery techniques applied to post-keratoplasty patients.
  • Analysis of outcomes for incisional keratotomies, photorefractive keratectomy (PRK), laser in-situ keratomileusis (LASIK), and intraocular lens implantation.
  • Evaluation of methods used to correct naturally occurring refractive errors applied to corneal transplant recipients.

Main Results:

  • Incisional keratotomies can address high astigmatism post-keratoplasty.
  • PRK and LASIK are effective for myopia, hyperopia, and astigmatism; LASIK generally shows better outcomes than PRK, though mitomycin-C improves PRK results.
  • Phakic and pseudophakic intraocular lenses offer solutions for high ametropia and astigmatism, but long-term data are limited.

Conclusions:

  • Refractive surgery significantly improves visual outcomes for patients following corneal transplantation.
  • Available refractive modalities offer viable alternatives for patients intolerant of spectacles and contact lenses.
  • Ongoing research promises further optimization of visual quality in the post-keratoplasty population.