Posters
Correction of high astigmatism after deep anterior lamellar keratoplasty by means of blunt relaxing dissection at the graft–host junction
Poster Details
First Author: E.Franco ITALY
Co Author(s): M. Elkadim J. Myerscough C. Bovone M. Busin
Abstract Details
Purpose:
To evaluate the outcomes of blunt relaxing dissection technique at the graft-host junction for correction of astigmatism following deep anterior lamellar keratoplasty (DALK) with a step wound configuration.
Setting:
Villa Igea Hospital (Forlì, Italy).
Methods:
High regular astigmatism following DALK was surgically corrected by blunt dissection at the graft-host junction in the steep meridian both circumferentially and centripetally. Keratometric astigmatism (KA), refractive astigmatism (RA), and best spectacle-corrected visual acuity (BSCVA) expressed in logarithmic units of the minimal angle of resolution (logMAR), were measured preoperatively and at 1, 6, 12, and 24 months postoperatively. Vector analysis of changes in KA was performed and surgically induced astigmatism (SIA) was calculated.
Results:
Forty eyes with at least one year of follow-up were included. No intra- or postoperative complications occurred. Mean KA (± Standard Deviation[SD]) decreased from 7.67 (±2.78) diopters (D) to 3.1 (±1.27) D at 1 month (p<0.001) with no significant change at one year. At 1 year, SIA (Mean ± SD) was 5.3 (±3.4) D, geometric mean of correction index was 0.59 and mean absolute angle of error was 6.97 (±4.4) degrees. BSCVA (Mean ± SD) improved from 0.21 (±0.2) logMAR preoperatively to 0.11 (±0.13) logMAR (P <0.001); RA decreased from 6.32 (±2.56) D preoperatively to 2.61 (±1.05) (P < 0.001).
Conclusions:
Blunt relaxing dissection of the graft host junction is a simple technique to reduce high astigmatism following DALK that minimizes complications typically encountered in alternative techniques. The refractive impact of the technique is immediate and remains stable at two years postoperatively.
Financial Disclosure:
None
