SMALL-DIAMETER, ROUND, ECCENTRIC PENETRATING KERATOPLASTIES AND CORNEAL TOPOGRAPHIC CORRELATION

Purpose: The purpose of the study is to report the outcome and postope rative topographic analysis of seven patients who underwent small-diam eter, round, eccentric penetrating keratoplasty. Methods: Seven patien ts underwent small-diameter, round, eccentric penetrating keratoplasty for a variety of corneal disorders (cataract wound necrosis and dehis cence or fistula, three patients; penetrating keratoplasty wound infec tion, two patients; corneal rheumatoid melt and perforation, one patie nt; localized fungal keratitis, one patient). Full-thickness corneal t ransplants ranged in size from 3.0 to 5.5 mm. The graft wound and sutu res spared the visual axis in all cases. Patients were observed for 7 to 42 months (mean, 21 months). All patients had postoperative topogra phic analysis. One of these also had preoperative analysis. Results: A ll grafts tectonically were effective in treating the intended conditi on. Best-corrected visual acuity was 20/30 or better in the four patie nts without pre-existing corneal transplants or dry eyes; 20/60 and 5/ 200 in the patients with previous central penetrating keratoplasties; and 20/40 in the patient with rheumatoid melt, There was no clinically significant regular or irregular astigmatism induced centrally by the eccentric graft in the four patients where visual acuity was 20/30 or better. Irregular astigmatism was noted in the other three patients. Conclusion: Small-diameter, eccentric penetrating keratoplasties may b e used successfully to treat various peripheral corneal disorders. In some cases, this can be performed without inducing high or irregular a stigmatism or both centrally.