Purpose:
To evaluate the results of three different methodologies to correct high amounts of astigmatism after penetrating keratoplasty.
Methods:
Retrospective analysis of patients with high astigmatism after penetrating keratoplasty who were treated with diamond blade astigmatic keratotomy (AK), femtosecond flap (IntraLase) conventional or wavefront guided LASIK (VISX), or a toric intraocular lens (Alcon). The key outcome measure was manifest cylinder. Enrollment in each type of correction was at the surgeon’s discretion.
Results:
A total of 35 eyes were studied. Manifest cylinder was less in the LASIK group than AK or Toric at 1, 3 and 6 months, however none of these differences were significant (Table 1). Mean LogMar uncorrected visual acuity (UCVA) was better with LASIK than AK at 3 months (P=0.01) and 6 months (P=0.002). Likewise, mean UCVA was better with Toric IOL than AK at 1 month (P=0.03), 3 months (P=0.047), and 6 months (P=0.0003).
Conclusions:
Femtosecond flap, excimer laser correction or a toric IOL are effective alternatives for reduction of post-keratoplasty astigmatism.
Keywords: astigmatism • refractive surgery