Long-term Results of Corneal Wedge Resection for High Postkeratoplasty Astigmatism

To present the results of corneal wedge resection in postkeratoplasty astigmatism, performed by the same surgeon using the same nomogram over a 25-year period.

This is a retrospective observational study. The sample was obtained from the medical records of all patients who underwent penetrating or deep lamellar keratoplasty, performed by a single surgeon from 1993 to 2018. All surgeries were performed using a diamond knife, on the flat meridian, involving the keratoplasty scar and closed with five 10-0 nylon sutures.

A total of 39 eyes were included. The keratometry measured cylinder improved from 7.99 ± 0.25 to 2.5 ± 0.3 D at 12 months and remained stable thereafter (a mean follow-up of 76.3 months). Best spectacle corrected visual acuity increased from 0.35 ± 0.01 to 0.57 ± 0.02 at 12 months and remained stable thereafter. There was a coupling ratio of 0.08 ± 0.03 D at 12 months. There were no corneal graft rejections or loss of best spectacle corrected visual acuity on this series.

Corneal wedge resection is a valuable resource for the management of high postkeratoplasty astigmatism. It is a safe and reproducible procedure, with stable results at 12 months and thereafter.