CORNEAL TOPOGRAPHY, ARCUATE KERATOTOMY, AND COMPRESSION SUTURES FOR ASTIGMATISM AFTER PENETRATING KERATOPLASTY

BACKGROUND: Twenty (20) patients with post-penetrating keratoplasty (P KP) (21 eyes) and excessive corneal astigmatism were studied using cor neal topography to determine placement of arcuate incisions and compre ssion sutures for astigmatism reduction. METHODS: Keratoplasty wounds and compression sutures were placed asymmetrically based on corneal to pography only. Incisions were at the donor-host junction at a depth of 500 microns. RESULTS: A 56% reduction in corneal astigmatism was acco mplished with an average cylinder reduction of 5.3 D. Keratometry read ings were reduced in 18 of 20 (90%) of eyes and refractive cylinder wa s reduced in 15 of 20 (75%) of eyes. Corrected visual acuity improved in 15 of 20 (75%) declined in 15%, and did not change in 10%. CONCLUSI ON: Visual acuity can be improved by manipulating the astigmatism afte r penetrating keratoplasty using corneal topography maps to determine placement of arcuate incisions and compression sutures.