Control of astigmatism aided by intraoperative keratometry

An evaluation of the final "sutures out" postoperative astigmatism in two groups of keratoconus patients undergoing penetrating keratoplasty is presented. Group I consists of a retrospective evaluation of keratoconus patients who underwent penetrating keratoplasty without using the Troutman Keratometer prior to suturing the button into position. Group II patients had their donor button rotated in the recipient bed until approximate sphericity was indicated by a circular reflex from the Troutman Keratometer before suturing into position. The mean final astigmatism with all sutures removed from Group I was 4.64, SD 1.89, and for Group II 2.27, SD 1.27. Selective positioning of the donor button using the Troutman Keratometer leads to a significant reduction in the final sutures out astigmatism in patients undergoing penetrating keratoplasty for keratoconus.