Management of Post-Penetrating Keratoplasty Astigmatism

Feizi, Sepehr

doi:10.5772/20152

Cited by 1 publication

(1 citation statement)

References 84 publications

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“…Relaxing incisions are made under topical anesthesia, on both sides of the steepest meridian, usually, with an arc length of 45° to 90°, and can be done in the 7.0 mm optical zone for maximal effect. The site and length are topography-guided [ 36 ]. In arcuate incisions, each incision is at the same distance from the visual axis to avoid uneven distribution of the force on the corneal architecture and allows rapid visual rehabilitation.…”

Section: Main Textmentioning

confidence: 99%

Post-keratoplasty astigmatism management by relaxing incisions: a systematic review

Yin

Hoffart

2017

Eye and Vis

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Postoperative visual acuity can be limited by post-keratoplasty astigmatism, even with a clear corneal graft. Astigmatism management can be performed by selective suture removal, adjustment of sutures, optical correction, photorefractive procedures, wedge resection, intra-ocular lens implantation, intracorneal ring segments, relaxing incisions with or without compression sutures and repeated keratoplasty. Relaxing incisions can be made in the graft, graft-host interface or host cornea. Despite the unpredictability of the method because the flat and steep meridians are usually not orthogonal after penetrating keratoplasty, with asymmetric power distribution, all the studies showed an overall reduction of refractive, keratometric or topographic astigmatism, ranging from 30% to 72% with manual or femtosecond-assisted techniques. Most patients with astigmatism higher than 6 diopters had residual cylinder less than or equal to 3 diopters, which can be treated by laser excimer ablation or secondary intraocular lens implantation.

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Section: Main Textmentioning

confidence: 99%