Standardised Arcuate Keratotomy in Post-Keratoplasty Patients

Abstract

Abstract: : Purpose: To describe the refractive outcomes when a standard arcuate keratotomy treatment is applied to post-keratoplasty eyes, regardless of the pre-operative astigmatism. Methods: We performed a retrospective review of the notes of 2 authors who perform a standardised arcuate keratotomy treatment. Patients who had undergone a standard treatment consisting of 2 incisions of 60 degrees arc length, 6mm diameter, and 600 micron depth were identified. Keratoscopy was not used to modify the incisions. Pre- and post-operative refraction and visual acuity, plus intra- and post-operative complications were recorded. Results: 22 eyes were identified. Pre-operative cylinder ranged from -3.5 to -21 D. At a minimum of 3 months post-op the cylinder ranged from -9 D to + 3 D. Plotting "change in cylinder" against "pre-op cylinder" yielded a trend line y = -0.849x - 1.4428, with an R² = 0.7 (fig 1). There were no significant complications. Conclusions: A standard treatment irrespective of pre-operative cylinder has a linear effect on the reduction of post-keratoplasty astigmatism. Patients with higher degrees of pre-op astigmatism experienced greater reductions in astigmatism following the treatment. This represents a reproducible technique against which other refractive techniques can be compared.  

Keywords: cornea: clinical science • refractive surgery