Autologous ipsilateral rotating penetrating keratoplasty

PURPOSE: To evaluate visual outcome after autologous ipsilateral rotating p enetrating keratoplasty. METHODS: The study included nine patients who consecutively underwent autol ogous ipsilateral rotating penetrating keratoplasty for treatment of trauma tic central corneal avascular scars. These patients were compared with 105 patients who consecutively underwent homologous central penetrating keratop lasty in the same study period for treatment of avascular corneal scars ext ending to the corneal periphery. All operations were performed by the same surgeon. Mean follow-up time for both study groups was 31.27 +/- 21.54 and 32.0 +/- 19.4 months, respectively. RESULTS: In the autologous rotating keratoplasty group, visual acuity incre ased significantly (P = 0.03; Wilcoxon test) from 0.13 +/- 0.11 preoperativ ely to 0.29 +/- 0.16 postoperatively, Refractive astigmatism and keratometr ic astigmatism, respectively, increased (P = 0.02) from 3.19 +/- 2.53 diopt ers and 3.20 +/- 2.24 diopters, respectively, preoperatively to 6.9 +/- 1.8 2 diopters and 9.55 +/- 4.32 diopters, respectively, postoperatively. Compa ring the study groups, postoperative visual acuity was significantly lower (P = 0.01), and keratometric astigmatism (P = 0.003) and refractive astigma tism (P = 0.01) were significantly higher in the autologous rotating kerato plasty group than in the control group. CONCLUSIONS: Autologous ipsilateral rotating penetrating keratoplasty compa red with homologous central penetrating keratoplasty is associated with a h igh postoperative refractive and keratometric astigmatism leading to a rela tively low postoperative visual acuity. It suggests that, in normal clinica l conditions when donor material is available and postoperative follow-up e xaminations can be performed, homologous central penetrating keratoplasty m ay be superior to autologous ipsilateral rotating keratoplasty. (Am J Ophth almol 2001;131:427-430, (C) 2001 by Elsevier Science Inc, All rights reserv ed).