SURGICAL-TREATMENT OF POSTKERATOPLASTY AS TIGMATISM WITH THE ARCUATE KERATOME

Purpose High postkeratoplasty astigmatism is a common postoperative co mplication which can limit the final functional result. Arcuate incisi ons are a possible surgical treatment. They can be performed with the arcuate keratome which provides regular incisions., The aim of this st udy was to evaluate the results obtained with this device in the corre ction of high postkeratoplasty astigmatism. Methods We retrospectively studied ten eyes operated for high postkeratoplasty astigmatism with the Hanna arcuate keratome. Arcuate keratotomy procedures were perform ed on the graft button in all. Before surgery, mean uncorrected visual acuity was 0.07 +/- 0.05. Best spectacle-corrected visual acuity was 0.33 +/- 0.20 and mean subjective cylinder was 6.1 +/- 1.71 D. Results After one month postoperatively, the mean best spectacle-corrected vi sual acuity (0.45 +/- 0.20) was significantly improved (p < 5%) and me an subjective cylinder (2.85 +/- 1.29 D) was significantly decreased ( p < 5%). Vector analysis showed a 5.59 D (+/- 3.63) mean astigmatism c orrection. Modifications of the spherical equivalent were not statisti cally significant. Astigmatism irregularity was not modified. Conclusi on Arcuate keratotomy carried out with the Hanna arcuate keratome is e ffective in reducing high postkeratoplasty astigmatism. It is easier t o perform than the standard manual technique. However, astigmatism cor rection predictibility should be improved.