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V. Jhanji, M. Constantinou, J. Beltz, R. B. Vajpayee; Corneal Wound Configuration After Penetrating Keratoplasty Using Anterior Segment Optical Coherence Tomography. Invest. Ophthalmol. Vis. Sci. 2009;50(13):604.
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To examine the wound configuration after penetrating keratoplasty (PKP) using anterior segment optical coherence tomography (OCT).
All PKP patients who were examined at the cornea clinic services of the Royal Victorian Eye and Ear Hospital, Melbourne, between February and November 2008, after having all their sutures removed were included. The wound profile was studied using anterior segment OCT.
A total of 159 graft-host sections from 29 eyes (24 patients, mean age 57 years±20) were analyzed. Majority of the patients included were operated for keratoconus (16 eyes, 55%) followed by endothelial dysfunctioning (8 eyes, 27.6%). The anterior graft-host junction was smooth in all the scans. Internal graft-host aberrations were observed in the form of host "ledge" (100 scans, 62.9%) and graft-host "steps" (59 scans, 37.1%).(Figure 1A, 1B) Keratoconus (34 ledges, 22 steps) patients had more host "ledges" while those transplanted for endothelial dysfunctions (12 ledges, 33 steps) had more "steps". Graft over sizing revealed an increased trend towards the occurrence of "steps". Mean astigmatism was higher in cases with "steps" (4.31 D±3.39) as compared to cases with "ledges" (1.75 D±1.87).
After PKP, the posterior graft-host malapposition occurs commonly and is associated with high astigmatism.
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