Topography-guided conductive keratoplasty: treatment for advanced keratoconus.

Abstract

PURPOSE:

To evaluate the use of topography-guided conductive keratoplasty in eyes with keratoconus.

DESIGN:

Interventional case series.

METHODS:

We examined 21 eyes in 21 patients with advanced keratoconus. Topography-guided conductive keratoplasty was performed with intraoperative monitoring of corneal astigmatism using a surgical keratometer. Uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), corneal topography, manifest refraction, intraocular pressure (IOP), corneal endothelial cell counts, complications, and eventual outcomes were evaluated.

RESULTS:

UCVA (logarithm of the minimal angle of resolution [logMAR]), which was 1.65 ± 0.49 preoperatively, improved to 1.04 ± 0.64 at 1 week (P < .001) and 1.12 ± 0.61 at 1 month after surgery (P < .001). BSCVA, which was 1.02 ± 0.56 preoperatively, improved to 0.76 ± 0.65 at 1 week (P = .026) and 0.76 ± 0.60 at 1 month after surgery (P = .003). Manifest refraction, which was -15.13 ± 6.66 diopters (D) before surgery, declined to -9.97 ± 6.71 D at 1 month after surgery (P = .002). Although corneal topography reverted to the preoperative pattern and UCVA and BSCVA also regressed toward preoperative values, 12 of 21 eyes were better able to tolerate and conduct normal daily activities using contact lenses. Five subjects have undergone or are considering corneal transplantation after unsatisfactory postoperative results. No serious perioperative complication was observed.

CONCLUSIONS:

Topography-guided conductive keratoplasty may be effective in reshaping corneal configuration in eyes with keratoconus, without serious complications, and possibly contributed to avoiding or delaying corneal transplantation.

• Authors: Naoko Kato, Ikuko Toda, Tetsuya Kawakita, Chikako Sakai, Kazuo Tsubota
• Journal: American journal of ophthalmology (Am J Ophthalmol) Vol. 150 Issue 4 Pg. 481-489.e1 (Oct 2010) ISSN: 1879-1891 [Electronic] United States
• PMID: 20692643 (Publication Type: Journal Article)
• Copyright: Copyright © 2010 Elsevier Inc. All rights reserved.

Topics

• Adolescent
• Adult
• Astigmatism (prevention & control)
• Catheter Ablation (methods)
• Cell Count
• Contact Lenses (statistics & numerical data)
• Corneal Stroma (physiopathology, surgery)
• Corneal Topography
• Endothelium, Corneal (pathology)
• Female
• Humans
• Intraocular Pressure
• Intraoperative Complications
• Keratoconus (physiopathology, surgery)
• Male
• Middle Aged
• Ophthalmologic Surgical Procedures
• Postoperative Complications
• Refraction, Ocular (physiology)
• Reoperation
• Visual Acuity (physiology)
• Young Adult