Safety and efficacy of two techniques for management of astigmatism post keratoplasty

Session Details

Session Title: Presented Poster Session: Refractive

Venue: Poster Village: Pod 3

First Author: : L.Martinez Perez SPAIN

Co Author(s): :    R. Tourino Peralba   L. Pena Madrid   I. Gonzalez Conde   M. Rodriguez Ares              

Abstract Details

Purpose:

Post-keratoplasty astigmatism management when all sutures have been removed, can be performed by relaxing and compressing procedures or opening and resuturing the donor cornea. Our objective is to evaluate the initial outcomes of these techniques to correct high astigmatism after keratoplasty.

Setting:

- Department of Ophthalmology, Complejo Hospitalario Universitario de Santiago de Compostela,Spain. - University of Santiago de Compostela. Santiago de Compostela, Spain.

Methods:

This retrospective non-comparative interventional study included 40 consecutive patients (40 eyes) who underwent relaxing and compressing procedures or opening and resuturing the donor cornea to correct high astigmatism. Surgical indication, technique used, changes in best spectacle-corrected visual acuity (BCVA), mean topographic astigmatism, preoperative and postoperative manifest refraction and complications were the main outcome measures.

Results:

Forty patients aged between 31 and 80 years (50.27  ± 14.32) were included. Keratoplasty indication was: 67.5% keratoconus, 20% herpetic keratitis, 2.5% refractive surgery and 10% other causes. In 67.5% incisional surgery was done and in 32.5% eyes, opening/resuture of the graft. Mean BCVA improved from 0.85 ± 0.34 LogMAR and 0.62 ± 0.34LogMAR preoperatively to 0.32 ± 0.26 and 0.48 ± 0.39 postoperatively and mean topographic cylinder decreased from 9.19±3.27 D and 9.55 ± 2.76 D preoperatively to 5.46 ± 3.46 D and 5.32±1.82 postoperatively in incisional surgery and opening/resuturing respectively (P<0.05). No surgical or postoperative complications were registred.

Conclusions:

Incisional surgery and opening/resuturing graft were relatively easy to perform, safe, and effective for treating post-keratoplasty astigmatism. There was a significant improvement in BCVA and topographic astigmatism with a very low rate of complications in both techniques. A larger series is required to refine the nomogram to achieve a greater reduction in cylinder and evaluate which technique can offer more advantages.

Financial Disclosure:

None