[Refractive and topographic changes of ipsilateral rotational autokeratoplasty with a crescent-shape 0.5 mm resection of the inferior cornea in keratoconus after a 24 months follow-up].

INTRODUCTION

Ipsilateral rotational penetrating autokeratoplasty technique may be an alternative to minimize the problem of long waiting lists for transplantation due to keratoconus.

PURPOSE: To report the visual outcomes in keratoconus patients after ipsilateral rotational penetrating autokeratoplasty technique (IRPAK) associated with a crescent-shape resection of 0.5 mm of the inferior cornea.

METHODS

According to a prospective, longitudinal, interventional, analytic study, the authors investigated the visual results of 15 patients (18 eyes) with keratoconus, who underwent an ipsilateral rotational penetrating autokeratoplasty, by two coincident trepanations superiorly and with a difference of 0.5 mm inferiorly. After resection of this corneal crescent, a 180° rotation of the corneal disk was performed, which was fixed with 24 sutures diametrically opposed. The patients were followed-up for a period of 24 months.

RESULTS

Comparing data of the first and second postoperative years to preoperative data, there were: significant improvements in visual acuity, vision lines and spherical equivalent; reduction of topographic astigmatism and maximum and mean corneal curvatures. There was also a decrease in corneal thickness associated to a reduction of corneal endothelial cell count.

CONCLUSION

There was an improvement of ophthalmologic parameters 6, 12 and 24 months after ipsilateral rotational penetrating autokeratoplasty associated with a crescent-shape resection of 0.5 mm of the inferior cornea, but along the follow-up there was reduction of visual acuity with increased astigmatism.