RETREPHINATION KERATOPLASTY FOR HIGH ASTIGMATISM AFTER PENETRATING KERATOPLASTY

PURPOSE: We report preliminary results of a new procedure for correcti ng high astigmatism after penetrating keratoplasty. METHODS: The proce dure entails full-thickness trephination along the original donor-reci pient junction with careful suturing in a combined interrupted and run ning fashion. Four eyes of four patients with severe astigmatism and m yopia after penetrating keratoplasty underwent the procedure. RESULTS: High preoperative cylinder ranging from 4.50 to 16.00 D (mean 9.00 D) was reduced to 0.50 to 3.50 D (mean 1.90 D) at the last examination ( between 3 to 6 months). Spherical equivalent myopia ranging from -2.00 to -10.25 D (mean -4.90 D) was essentially unchanged at piano to -9.0 0 D (-4.70 D) at the last examination. Overall, there was a mean refra ctive cylinder reduction of 7.10 D (79%). CONCLUSION: Retrephination a fter penetrating keratoplasty appears to be an acceptable alternative for correcting high astigmatism, and had only a small effect on the le vel of myopia.