Wedge resection for postkeratoplasty astigmatism

Twelve patients underwent a modified wedge resection after keratoplasty; 11 of them were followed for 6 to 24 months. The average preoperative astigmatism was 15.40 diopters (range, 12.50 to 22.00 D). The wedge was resected from the donor side and the wound closed with 10-0 or 11-0 Mersilene sutures. Postoperatively, the average astigmatism was 4.36 D (range, 1.50 to 9.00 D), and the visual acuity, corrected with spectacles, was 20/40 or better in five cases (45%). Complications included high residual astigmatism or irregular astigmatism and extensive scarring due to the use of Mersilene sutures. Overall, modified resection of the wedge is an effective technique for managing postkeratoplasty high astigmatism.