Intraoperative videokeratography in penetrating keratoplasty and excimer laser-assisted lamellar keratoplasty for keratoconus.

Abstract

PURPOSE:

To evaluate the usefulness of intraoperative computerized corneal topographic data in excimer laser-assisted lamellar keratoplasty (ELLK) and penetrating keratoplasty (PK).

METHODS:

Prospective, comparative, interventional case series. Intra- and postoperative videokeratography (Keratron Scout) evaluation was performed on 30 eyes of 30 consecutive patients affected by keratoconus (16 men and 14 women; mean age 32.63±8.02 years) submitted to ELLK (15 eyes) using 16 interrupted 10-0 nylon stitches or to PK (15 eyes) using a 12-bite 10-0 nylon double-running continuous suture.

RESULTS:

In the ELLK group, the mean intraoperative keratometric astigmatism was 12.06±4.86 diopters (D), which changed to 5.19±2.51 D after topography-guided intraoperative suture adjustment. In the PK group, intraoperative keratometric astigmatism was 10.18±3.88 D, which changed to 3.49±0.41 D. After 24 months (sutures out), the mean videokeratographic keratometric astigmatism was 3.35±1.96 D in the ELLK group and 3.37±0.92 D in the PK group. The Alpins method of vector analysis showed some significant changes especially in the ELLK group.

CONCLUSIONS:

In keratoplasty surgery, videokeratography is useful for suture adjustment. In the PK group, using a double-running suture technique, the postoperative astigmatism (after all sutures were removed) was similar to the astigmatism measured intraoperatively by videokeratography.

• Authors: Leopoldo Spadea, Arianna Fiasca, Simone Federici
• Journal: Journal of refractive surgery (Thorofare, N.J. : 1995) (J Refract Surg) Vol. 26 Issue 9 Pg. 660-8 (Sep 2010) ISSN: 1081-597X [Print] United States
• PMID: 19928693 (Publication Type: Comparative Study, Journal Article)
• Copyright: Copyright 2010, SLACK Incorporated.

Topics

• Adult
• Corneal Topography
• Corneal Transplantation
• Female
• Humans
• Keratoconus (surgery)
• Keratoplasty, Penetrating
• Lasers, Excimer (therapeutic use)
• Male
• Middle Aged
• Monitoring, Intraoperative
• Prospective Studies
• Young Adult