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Corneal topography, arcuate keratotomy, and compression sutures for astigmatism after penetrating keratoplasty
1Department of Ophthalmology, University of Kentucky, Lexington, USA.
Background:
Twenty (20) patients with post-penetrating keratoplasty (PKP) (21 eyes) and excessive corneal astigmatism were studied using corneal topography to determine placement of arcuate incisions and compression sutures for astigmatism reduction.
Methods:
Keratoplasty wounds and compression sutures were placed asymmetrically based on corneal topography only. Incisions were at the donor-host junction at a depth of 500 microns.
Results:
A 56% reduction in corneal astigmatism was accomplished with an average cylinder reduction of 5.3 D. Keratometry readings were reduced in 18 of 20 (90%) of eyes and refractive cylinder was reduced in 15 of 20 (75%) of eyes. Corrected visual acuity improved in 15 of 20 (75%) declined in 15%, and did not change in 10%.
Conclusion:
Visual acuity can be improved by manipulating the astigmatism after penetrating keratoplasty using corneal topography maps to determine placement of arcuate incisions and compression sutures.
