Circular Keratotomy Combined With Wedge Resection in the Management of High Astigmatism After Penetrating Keratoplasty.

OBJECTIVE

To evaluate the effectiveness of circular keratotomy combined with wedge resection for the management of high astigmatism after penetrating keratoplasty (PK).

METHODS

The study included seven eyes of seven patients with previous PK who underwent circular keratotomy combined with wedge resection. The uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA), spherical equivalent (SE) refraction, and keratometric powers obtained by corneal topography were evaluated. The power vector method was used to analyze the astigmatic change postoperatively.

RESULTS

The mean follow-up period was 18.42±8.56 months (range 12-33 months). Uncorrected visual acuity, BCVA, and SE were improved in all eyes postoperatively. The mean preoperative astigmatism reduced from 15.11±5.48 D (range, 10.0-24.4 D) to 4.98±3.01 D (range, 2.2-9.6 D), postoperatively. According to the vector analysis, the overall mean surgically induced astigmatism at last visit was 12.87±6.20 D. The most common complication was the loosening of sutures occurred in five eyes within 2 months.

CONCLUSIONS

Circular keratotomy combined with corneal wedge resection is a favorable option for the management of high astigmatism after PK.