Astigmatism after penetrating keratoplasty

Abstract

The Authors retrospectively evaluated the evolution of corneal astigmatism 6, 12 and 24 months after penetrating keratoplasty in 75 eyes by comparing 2 suture techniques: running suture (RS) in 14 cases vs interrupted suture (IS) in 61 cases. The mean keratometric astigmatism in patients with RS was 7.75 +/- 3.10 D at 6 months, 5.89 +/- 2.50 D at 12 months and 3.90 +/- 1.70 D at 24 months. In patients with IS these values were 4.82 +/- 4.00 D at 6 months, 2.81 +/- 1.60 D at 12 months and 2.77 +/- 1.34 D at 24 months. A significant lower astigmatism (P < 0.05) was noted after using IS at 6 and 12 months. At 24 months, however, this difference was no longer statistically significant (P > 0.3). The IS suture allowed a better control of the post-surgical astigmatism, and a more rapid recovery of the visual acuity.

The Intrastromal Corneal Ring in Penetrating Keratoplasty—Long-term Results of a Prospective Randomized Study

“…The mean astigmatism of 4.4 D of our 2 groups resembles the results reported by other penetrating keratoplasty investigators. 2,[5][6][7][8][9][10][11][12][13] In their intrastromal corneal ring study, Ehrich and Duncker 7 observed less astigmatism in the ring group, although their results were not statistically significant. In a second retrospective nonrandomized study, Krumeich and Duncker 22 compared results after 179 penetrating keratoplasties using an intrastromal corneal ring with those of 101 penetrating keratoplasties without a ring.…”

“…1,3,4 Average postoperative astigmatism differs considerably, ranging between 2.5 and 7 diopters (D) in recent studies. 2,[5][6][7][8][9][10][11][12][13] Several new approaches have been developed addressing the problem of postoperative astigmatism after penetrating keratoplasty; most concern new trephination techniques.…”

Comparison of Long-Term Outcomes of Femtosecond Laser-Assisted Keratoplasty with Conventional Keratoplasty

“…Improper centration of the donor cornea to the artificial anterior chamber, donor astigmatism, asymmetric suturing, tissue remodeling during the postoperative course, as well as suction, deformation, and compression of the graft are additional contributors to high and irregular graft astigmatism. [22][23][24][25][26] We analyzed the full cohort of patients, regardless of whether sutures had been removed or remained in situ, to assess the real-life efficacy as experienced by the patients. This is important because suture removal was guided by the power of the postoperative keratometric astigmatism; that is, the decision to leave the sutures in place for a longer period was generally suggested when the visual acuity was good or excellent.…”

Comparison of Complication Rates and Postoperative Astigmatism Between Nylon and Mersilene Sutures for Corneal Transplants in Patients with Fuchs Endothelial Dystrophy

“…Although there is no general agreement regarding which suture technique is the best to reduce astigmatism, it is obvious that suturing technique might play a role in postkeratoplastic astigmatism. 4,28,29 All statistical analyses were therefore adjusted for this variable. Controversy consists of the use of Mersilene sutures in penetrating keratoplasty.…”