Current Approaches for Management of Postpenetrating Keratoplasty Astigmatism

A successful corneal graft requires both clarity and an acceptable refraction. A clear corneal graft may be an optical failure if high astigmatism limits visual acuity. Intraoperative measures to reduce postkeratoplasty astigmatism include round and central trephination of cornea with an adequate si...

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Main Authors: Sepehr Feizi, Mohammad Zare
Format: Article
Language:English
Published: Wiley 2011-01-01
Series:Journal of Ophthalmology
Online Access:http://dx.doi.org/10.1155/2011/708736
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author Sepehr Feizi
Mohammad Zare
author_facet Sepehr Feizi
Mohammad Zare
author_sort Sepehr Feizi
collection DOAJ
description A successful corneal graft requires both clarity and an acceptable refraction. A clear corneal graft may be an optical failure if high astigmatism limits visual acuity. Intraoperative measures to reduce postkeratoplasty astigmatism include round and central trephination of cornea with an adequate size, appropriate sutures with evenly distributed tension, and perfect graft-host apposition. Suture manipulation has been described for minimising early postoperative astigmatism. If significant astigmatism remains after suture removal, which cannot be corrected by optical means, then further surgical procedures containing relaxing incisions, compression sutures, laser refractive surgery, insertion of intrastromal corneal ring segments, wedge resection, and toric intraocular lens implantation can be performed. When astigmatism cannot be reduced using one or more abovementioned approaches, repeat penetrating keratoplasty should inevitably be considered. However, none of these techniques has emerged as an ideal one, and corneal surgeons may require combining two or more approaches to exploit the maximum advantages.
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spelling doaj-art-995754f490f64e42aae0b2d90e0b56a42025-08-20T02:10:17ZengWileyJournal of Ophthalmology2090-004X2090-00582011-01-01201110.1155/2011/708736708736Current Approaches for Management of Postpenetrating Keratoplasty AstigmatismSepehr Feizi0Mohammad Zare1Ophthalmic Research Center and Department of Ophthalmology, Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran 16666, IranOphthalmic Research Center and Department of Ophthalmology, Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran 16666, IranA successful corneal graft requires both clarity and an acceptable refraction. A clear corneal graft may be an optical failure if high astigmatism limits visual acuity. Intraoperative measures to reduce postkeratoplasty astigmatism include round and central trephination of cornea with an adequate size, appropriate sutures with evenly distributed tension, and perfect graft-host apposition. Suture manipulation has been described for minimising early postoperative astigmatism. If significant astigmatism remains after suture removal, which cannot be corrected by optical means, then further surgical procedures containing relaxing incisions, compression sutures, laser refractive surgery, insertion of intrastromal corneal ring segments, wedge resection, and toric intraocular lens implantation can be performed. When astigmatism cannot be reduced using one or more abovementioned approaches, repeat penetrating keratoplasty should inevitably be considered. However, none of these techniques has emerged as an ideal one, and corneal surgeons may require combining two or more approaches to exploit the maximum advantages.http://dx.doi.org/10.1155/2011/708736
spellingShingle Sepehr Feizi
Mohammad Zare
Current Approaches for Management of Postpenetrating Keratoplasty Astigmatism
Journal of Ophthalmology
title Current Approaches for Management of Postpenetrating Keratoplasty Astigmatism
title_full Current Approaches for Management of Postpenetrating Keratoplasty Astigmatism
title_fullStr Current Approaches for Management of Postpenetrating Keratoplasty Astigmatism
title_full_unstemmed Current Approaches for Management of Postpenetrating Keratoplasty Astigmatism
title_short Current Approaches for Management of Postpenetrating Keratoplasty Astigmatism
title_sort current approaches for management of postpenetrating keratoplasty astigmatism
url http://dx.doi.org/10.1155/2011/708736
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