Effect of hinged lamellar keratotomy on postkeratoplasty eyes.

Abstract

PURPOSE:

To evaluate the effect of a hinged lamellar keratotomy on refraction, vision, and corneal topography of postkeratoplasty eyes with high-degree astigmatism.

DESIGN:

Noncomparative, interventional case series.

PARTICIPANTS:

A hinged lamellar keratotomy was performed on nine eyes of nine patients at least 9 months after penetrating keratoplasty and with high-degree astigmatism. All patients were spectacle and contact lens intolerant.

INTERVENTION:

A superiorly hinged lamellar keratotomy (corneal flap), 160 microm in thickness and 9 mm in diameter, was created on all eyes included in this study. Each patient was examined 1 day, 1 month, and 3 months after surgery.

MAIN OUTCOME MEASURES:

Uncorrected visual acuity, best spectacle-corrected visual acuity, refraction, computerized analysis of corneal topography.

RESULTS:

At each postoperative examination time, there was a significant reduction in both average spherical equivalent (P < 0.05) and average absolute value of astigmatism (P < 0.01) over mean preoperative values. The major changes were seen as early as 1 day after surgery, but both progression and regression of the effect were documented at later postoperative examinations. In all patients best spectacle-corrected acuity was maintained or improved after the procedure. Postoperatively, four patients could be successfully corrected either with spectacles (n = 2) or with gas-permeable contact lenses (n = 2). There were no surgical flap or corneal graft complications.

CONCLUSIONS:

Hinged lamellar keratotomy improves vision and refraction of postkeratoplasty eyes with high-degree astigmatism. In some cases it may be so effective as to make planned excimer laser treatment unnecessary.

• Authors: M Busin, R C Arffa, L Zambianchi, G Lamberti, A Sebastiani
• Journal: Ophthalmology (Ophthalmology) Vol. 108 Issue 10 Pg. 1845-51; discussion 1851-2 (Oct 2001) ISSN: 0161-6420 [Print] United States
• PMID: 11581060 (Publication Type: Journal Article)

Topics

• Adult
• Aged
• Anisometropia (surgery)
• Astigmatism (physiopathology)
• Corneal Stroma (surgery)
• Corneal Topography
• Female
• Humans
• Keratomileusis, Laser In Situ
• Keratoplasty, Penetrating
• Male
• Middle Aged
• Postoperative Complications (surgery)
• Refraction, Ocular
• Surgical Flaps
• Treatment Outcome
• Visual Acuity