Long‐term follow‐up of astigmatic keratotomy for corneal astigmatism after penetrating keratoplasty

Böhringer, Daniel; Dineva, Nina; Maier, Philip; Birnbaum, Florian; Kirschkamp, T.; Reinhard, Thomas; Eberwein, Philipp

doi:10.1111/aos.13061

Cited by 16 publications

(7 citation statements)

References 22 publications

(17 reference statements)

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“…The long-term outcome of a FLAK or AK is uncertain. Fadlallah et al [ 48 ] reported a change in astigmatism at a follow-up after FLAK, as did Böhringer and colleagues [ 53 ] after an AK. This cohort had a mean follow-up time of 24 months post-AK 2, a considerable amount of time, with satisfactory anatomical and refractive outcomes.…”

Section: Discussionmentioning

confidence: 88%

Repeated Femtosecond Laser-Assisted Astigmatic Keratotomies in Post-Keratoplasty Eyes

Levinger

Levinger²,

Erdinest

et al. 2022

JCM

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Visual rehabilitation after a keratoplasty is often compromised due to high amounts of residual astigmatism. Femtosecond laser-assisted astigmatic keratotomy (FLAK) is gaining popularity in decreasing this astigmatism. Though one set of two incisions suffices in most cases, sometimes the treatment proves insufficient and additional treatment is required. This case series evaluates the outcomes in patients who underwent two consecutive FLAK sets to correct post-keratoplasty residual astigmatism. All repeated FLAK cases performed on post-keratoplasty eyes were reviewed in a high-volume clinic as a non-comparative retrospective case series. The data extracted include the procedure parameters, time between procedures, refraction including sphere, astigmatism, spherical equivalent (SE), and uncorrected and best-spectacle-corrected distance visual acuity (UDVA, BSDVA, respectively). Eleven eyes of eleven patients aged 25.5 ± 10 treated with more than one FLAK procedure were identified. The average follow-up time was 6 months after the first FLAK and 24 ± 10 months after the second. The second FLAK was performed six months after the first. The preoperative mean astigmatism was −9.59 ± 2.36 D. At the final follow-up, the mean astigmatism decreased to −5.38 ± 1.79 D (p = 0.001). Repeated FLAK procedures achieved a significant and stable reduction of astigmatism in post-keratoplasty eyes. This procedure shows safety and effectivity in these complex eyes and may prevent the need for a further keratoplasty.

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Section: Discussionmentioning

confidence: 88%

Repeated Femtosecond Laser-Assisted Astigmatic Keratotomies in Post-Keratoplasty Eyes

Levinger

Levinger²,

Erdinest

et al. 2022

JCM

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“…Corneal scarring, reduced BCVA, as well as pronounced corneal steepening have been documented. 6 Aside from limited evidence in support of astigmatic keratotomy, 7 contact lenses are often the option of choice to mitigate these consequential visual problems. 8 …”

Section: Discussionmentioning

confidence: 99%

Mini-Scleral Contact Lens for Asian Eyes Post-Penetrating Keratoplasty with Smaller Palpebral Aperture: Case Reports

Kim

Park

Joo

2021

OPTO

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To report the use of miniscleral contact lenses (MSCLs) with diameter of 14.7 mm for Asian eyes to improve vision in patients after penetrating keratoplasty (PKP) surgery. Methods: Two patients with high corneal astigmatism post-PKP were evaluated for a contact lens fitting. Visual acuity, slit lamp, and anterior segment OCT findings before and after fitted the lens of 14.7 mm diameter were recorded. Results: A Kmax of case 1 and 2 were 52.8 D and 76.9 D, respectively at the first visit. Both patients were successfully fit with MSCLs, showing adequate corneal clearance of over 250 μm with no corneal touch on OCT and sufficient limbal clearance and edge alignment. MSCLs use resulted in improved comfort and visual acuity of 20/30 or better. Conclusion: MSCLs with diameter of 14.7 mm can be considered a safe and effective option for patients with highly steep corneas post-PKP surgery in Asian eyes.

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“…6 They achieved 4.37 D decrease in eyes with a preoperative astigmatism between 6-9 D and 6.23 D decrease in eyes with a preoperative astigmatism between 9-16.5 D. They found AK safe and effective and suggested an arc length of 60°for astigmatism of 6-9 D, and 75°for astigmatism >9 D. Sy et al combined AK with conductive keratoplasty for astigmatism >5 D and achieved a regression of 5.5 D. 19 Böhringer et al in their study have reported that AK is an effective tool to reduce post-keratoplasty astigmatism with better results in regular corneal astigmatism but limited predictability of refractive results. 20 They have suggested that AK may still be an elegant option to reduce postoperative astigmatism after PK. FLAK surgery which is able to create quality arcuate incisions with precise length, depth, radius, and symmetry that were pre-viously hard to achieve by manual techniques is commonly used to correct post-keratoplasty astigmatism.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Arcuate Keratotomy Incisions in Correction of High Post-Keratoplasty Astigmatism

Yüksel¹,

Kartı²,

Aydin³

et al. 2018

Turkiye Klinikleri J Ophthalmol

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Long‐term follow‐up of astigmatic keratotomy for corneal astigmatism after penetrating keratoplasty

Cited by 16 publications

References 22 publications

Repeated Femtosecond Laser-Assisted Astigmatic Keratotomies in Post-Keratoplasty Eyes

Repeated Femtosecond Laser-Assisted Astigmatic Keratotomies in Post-Keratoplasty Eyes

Mini-Scleral Contact Lens for Asian Eyes Post-Penetrating Keratoplasty with Smaller Palpebral Aperture: Case Reports

Efficacy of Arcuate Keratotomy Incisions in Correction of High Post-Keratoplasty Astigmatism

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