Surgical correction of postkeratoplasty astigmatism with the Hanna arcitome

Purpose: To report the result of arcuate keratotomy performed with the Hann a arcitome in patients with postkeratoplasty astigmatism. Setting: Department of Ophthalmology, Saint-Antoine Hospital, Paris VI Univ ersity, Paris, France. Methods: This retrospective study comprised 22 eyes (22 patients) with post keratoplasty astigmatism. Paired symmetrical arcuate keratotomy was perform ed with the Hanna arcitome. Outcome measures included refraction, videokera tography, and keratometry. Results: At 6.6 months +/- 8.9 (SD) after surgery, the mean increase in bes t spectacle-corrected visual acuity (BSCVA) was 2.1 +/- 2.4 lines. Thirteen eyes gained 2 lines or more of BSCVA, and 15 gained 3 lines or more of unc orrected visual acuity. Two patients had a decrease in BSCVA. 1 had lens op acification unrelated to arcuate keratotomy and 1, increased corneal irregu larity. Mean refractive astigmatism was 6.94 +/- 2.11 diopters (D) preopera tively and 3.85 +/- 1.95 D postoperatively (P < .01). Mean change in kerato metric astigmatism was -51 +/- 36%. Astigmatism decreased in 21 eyes as mea sured by manifest refraction, keratometry, and videokeratography; it increa sed in 1 cornea with a microperforation. Conclusions: The results of arcuate keratotomy performed with the Hanna arc itome were comparable to those with freehand relaxing incisions. The instru ment made safer and more uniform arcuate incisions than a freehand techniqu e.