Bilateral corneal wedge resection in a patient with high residual astigmatism after penetrating keratoplasty: A case report

Purpose: To report a case of high astigmatism after penetrating keratoplasty treated with corneal wedge resection. Observations: We report our experience with a patient treated with corneal wedge excision for high astigmatism. A thin wedge of corneal tissue was removed from the donor-recipient interface.The wedge started on the flattest axis by keratometry and extended 20 degrees on each side; the same procedure was performed on the contralateral flat axis. The wound was closed with 10-0 nylon. We report the pre and post-operative topography. Results: The mean preoperative astigmatism by keratometry was 15 diopters (D). After wedge resection, the mean astigmatism was 1.7 D.The mean reduction in astigmatism by keratometry was of 13.3 D. Conclusion: Corneal wedge resection is a good option for high residual astigmatism after penetrating keratoplasty when the patient is not a candidate for other conservative treatments.