Refractive procedures for correction of postkeratoplasty astigmatism
Gernot I. W. Duncker
University Eye Hospital of Halle
Summary: Beside immune reactions high astigmatism is the mayor problem after keratoplasty. Procedures for correction of postkeratoplasty astigmatism are suture adjustment or renewing of the running suture, early suture removal, early fitting of toric contact lenses, arcuate or circular keratotomies, LASIK surgery, implantation of toric posterior chamber intraocular lenses or even regrafting in relapsing keratokonus for instance. The indication for each of these procedures will be discussed. The best way, however, to deal with PKP astigmatism is prevention. Therefore, guided trephine systems like the so-called GTS or the Deutschmann trephine are recommended. Exact suturing under keratoscopic control and the use of intracorneal rings especially in trauma cases are helpful, too. The aim of the correction of postkeratoplasty astigmatism is getting a good uncorrected visual acuity after keratoplasty.
Keywords: astigmatism, keratoplasty, toric PCL, LASIK, AK, CK, guided trephine system.