Original articleRepeat Keratoplasty for Correction of High or Irregular Postkeratoplasty Astigmatism in Clear Corneal Grafts
Section snippets
Patient and donor details
This retrospective study was a longitudinal, single-center, clinical, nonrandomized, consecutive case series. The study population consisted of 17 consecutive eyes of 16 patients (10 eyes of 10 males; 7 eyes of 6 females. Patient age was 54.9 ± 12.6 years (range, 36.1–76.0 years). The diagnosis was keratoconus (16 eyes of 15 patients) and Fuchs’ dystrophy (1 eye). Nine of the operated eyes (53%) were left eyes. Two of the donor corneas (12%) had been preserved in organ culture. Other donor
Results
From examination of the preoperative photographs, the graft was classified as “eccentric” (range, 0.3–1.2 mm) in 10 eyes (71%). The graft-host junction was in no case located at the optical axis or the limbus.
The pre- and postoperative values of the outcome parameters are shown in Table.
Twelve months after PK (with all sutures still present), BCVA and PVA were significantly improved (P = .04 or better), from preoperative values of 0.2/0.5 to 0.5/0.7, respectively. Central corneal power
Discussion
Postkeratoplasty astigmatism often impedes visual rehabilitation of patients after corneal transplantation, even with clear grafts. Twelve months after PK (before suture removal), and also after first and after second suture removal, BCVA, PVA, and (before final suture removal) mean astigmatism measures showed significant improvement compared with preoperative mean values (Table). However, after removal of the second suture, astigmatism again increased significantly. Thus, the most conspicuous
Since graduating in 1999 from the Semmelweis University in Budapest, Hungary, Dr. Nópra Szentmáry has worked at the 1st Department of Ophthalmology of the University and since 2000 has been performing research work at this clinic and at the University of Erlangen, Germany. Primary research interest: wound healing of the cornea.
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Post-penetrating keratoplasty astigmatism
2022, Survey of OphthalmologyCitation Excerpt :In a series of 4 eyes, Krueger and coworkers found a mean reduction in of 7.1D in refractive cylinder, with no significant change in spherical error, at 3–6 months following the surgery.140 Another study evaluated the results of repeat PKP in eyes with high astigmatism after primary PKP, but otherwise clear grafts.262 Of the 17 eyes studied, 16 eyes had primary PKP done for keratoconus and 1 eye was operated for Fuchs endothelial dystrophy.
Corneal transplantation after failed grafts: Options and outcomes
2021, Survey of OphthalmologyCitation Excerpt :In 3 patients, in spite of minimal reductions in keratometric astigmatism, an improvement in spectacle tolerance was still observed, leading the authors to conclude the procedure was successful in reducing irregular astigmatism. If these methods are deemed inappropriate or fail, repeat keratoplasty is an option.142,186 Patel and coworkers described a series of 15 eyes in 13 patients that underwent repeat PK for late ectasia.142
Development of a nomogram for femtosecond laser astigmatic keratotomy for astigmatism after keratoplasty
2016, Journal of Cataract and Refractive SurgeryFemtosecond laser-assisted intrastromal corneal ring segment implantation for high astigmatism correction after penetrating keratoplasty
2013, Journal of Cataract and Refractive Surgery
Since graduating in 1999 from the Semmelweis University in Budapest, Hungary, Dr. Nópra Szentmáry has worked at the 1st Department of Ophthalmology of the University and since 2000 has been performing research work at this clinic and at the University of Erlangen, Germany. Primary research interest: wound healing of the cornea.
Supported in part by the German Ministry for Education and Research (BMBF, IZKF Erlangen, Project B13), by the Neurocenter Erlangen, Erlangen, Germany and by a travel grant from the Society of European Ophthalmologists (SOE), London, Great Britain.