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Long‐term follow‐up of astigmatic keratotomy for corneal astigmatism after penetrating keratoplasty
Author(s) -
Böhringer Daniel,
Dineva Nina,
Maier Philip,
Birnbaum Florian,
Kirschkamp Thomas,
Reinhard Thomas,
Eberwein Philipp
Publication year - 2016
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/aos.13061
Subject(s) - medicine , keratometer , astigmatism , ophthalmology , visual acuity , keratoconus , corneal topography , refractive error , cornea , optics , physics
Purpose To report the long‐term stability of paired arcuate corneal keratotomies ( AK s) in patients with high regular postpenetrating keratoplasty astigmatism. Methods Retrospective chart review of best‐corrected visual acuity, refraction and keratometric values of 41 eyes with AK between 2003 and 2012. Results Magnitude of median target induced astigmatism vector was 9.2 dioptres (Dpt). We reached a median magnitude of surgically induced astigmatism vector of 9.81 Dpt and a median magnitude of difference vector of 5.5 Dpt. In keratometry, we achieved a net median astigmatism reduction by 3.3 Dpt. The average correction index was 1.14, showing a slight overcorrection. Irregularity of keratometric astigmatism increased by 0.6 Dpt, and spherical equivalent changed by 1.75 Dpt. Monocular best spectacle corrected visual acuity increased from preoperatively 20/63 (0.5 log MAR ) to 20/40 (0.3 log MAR ) postoperatively. Median gain on the ETDRS chart was two lines. Long‐term follow‐up showed a median keratometric astigmatic increase by 0.3 Dpt per year. Conclusion Arcuate corneal keratotomies is a safe and effective method to reduce high regular corneal astigmatism following penetrating keratoplasty but has limited predictability. The long‐term follow‐up shows an increase of keratometric astigmatism by 0.3 Dpt/year, equalizing the surgical effect after 10 years.