Repeat Keratoplasty for Correction of High or Irregular Postkeratoplasty Astigmatism in Clear Corneal Grafts

Management of Post-Penetrating Keratoplasty Astigmatism

“…Reporting a small group of patients who underwent repeat PK using the 193-nm Zeiss-Meditec MEL-60 excimer laser and employing double running sutures, Szentmary et al 43 observed a significant decrease in central graft power and an improvement in astigmatism with sutures in place. However, astigmatism increased significantly after second suture removal.…”

“…When, a small amount of astigmatism is achieved through suture manipulation, the sutures are left in as long as possible, until they fray or break. 18,43 …”

Efeito da remoção seletiva da sutura no astigmatismo nos transplantes de córnea pós-ceratocone

“…No ceratocone, quando a cirurgia se torna necessária do ponto de vista anatômico e funcional, a córnea quase sempre se encontra com protrusão acentuada o que impossibilita a avaliação refratométrica adequada e até mesmo adaptação de lentes de contato. O transplante penetrante de córnea e o adequado manejo pós-operatório da sutura possibilitam recuperação visual significativa nestes pacientes que na maior parte são pacientes jovens e em idade francamente produtiva (1) .…”

Ultrasound biomicroscopy as a diagnostic method of corneal degeneration and inflammation

“…PKP offers good longterm visual rehabilitation for KC (79,(94)(95)(96)(97)(98). High postoperative corneal astigmatism, sometimes seen after PKP, could prevent good visual rehabilitation even when a graft is clear and otherwise surgically successful.…”

“…The resection is centered on the negative axis and a wedge of tissue is removed from both the host and the donor, using a nomogram (99). Repeating PKP leads to intraoperative and postoperative complications, therefore this should be only considered when all other options have failed (98,101).…”