Prospective Corneal Topographic Analysis in Surgery for Postkeratoplasty Astigmatism

Astigmatic keratotomy for post-keratoplasty astigmatism

“…McCartney et al 11 and Frangieh et al 2 combined astigmatic keratotomies with compression sutures and achieved a greater reduction in cylinder of 68% and 81%, respectively. Agapitos et al 12 analyzed 6 different astigmatic procedures and found the combination of relaxing incisions and compression sutures to be the most predictable, although the accuracy of all procedures was noted to be highly variable.…”

Arcuate Relaxing Incisions Guided by Corneal Topography for Postkeratoplasty Astigmatism

“…To analyze as homogeneous a group of patients as possible, all patients had to meet specific criteria that have been recommended by other authors. 26,40 These criteria included the following: best spectacle corrected or pinhole visual acuity Q20/40, grade 1 or 2 centered graft relative to the corneal light reflex, corneal light reflex within 0.5 mm of the center of the entrance pupil, minimum of 10 topographic rings for analysis, stable posttransplant astigmatism of at least 5.0 D measured by an office keratometer, minimum of 3 months postremoval of all sutures before relaxing incision surgery, minimum of 6 months follow up after relaxing incision surgery to avoid reporting early data that may hide possible regression effects of the surgery, and no wound abnormality such as graftYhost edge lift to account for excessive astigmatism. Approval from the Institutional Review Board/Ethics Committee was obtained.…”

Management of post-keratoplasty astigmatism

“…11 Similarly, recipient bed vascularization leading to poor or excessive wound-healing response in different sectors can cause warpage of donor tissue and consequent astigmatism. 11,12 Intraocular pressure 13 and deceased scleral rigidity 14 could also play small contributory roles.…”