Astigmatism Research Today is a free monthly online journal that collates and summarizes the latest research about Astigmatism, including details on cornea, retina, treatment, types, signs, tests.

Corneal curvature after penetrating keratoplasty before and after suture removal: a comparison between keratoconus and Fuchs' dystrophy.

Seitz B, Langenbucher A, Szentmary N, Naumann GO

Department of Ophthalmology, University of Erlangen-Nurnberg, Erlangen, Germany. berthold.seitz@uniklinikum-saarland.de

PURPOSE: To assess the differences concerning corneal curvature and visual acuity after penetrating keratoplasty (PKP) comparing keratoconus (KC) and Fuchs' dystrophy (FUCHS). METHODS: Inclusion criteria for this prospective, comparative, interventional study were: (1) one surgeon, (2) central round nonmechanical excimer laser PKP without previous surgery, (3) FUCHS (n = 35) or KC (n = 52), (4) standardized graft size (7.5-8.0 mm) and technique, 16-bite double running cross-stitch suture. In 69% of FUCHS, a triple procedure was performed. The main outcome measures were: keratometric astigmatism, surface regularity index, surface asymmetry index, keratometric central corneal power and best-corrected visual acuity before (1.2 +/- 0.4 years) and after suture removal (1.8 +/- 0.6 years). RESULTS: Astigmatism did not differ significantly between KC and FUCHS (p > 0.1) before (3.3 dpt vs. 3.5 dpt median) and after suture removal (2.5 dpt vs. 3.0 dpt). Surface regularity index and surface asymmetry index were significantly higher in FUCHS than in KC (p < 0.001) at both time stages. Central power was significantly greater in KC than in FUCHS (p < 0.001) with sutures in place. Due to a significant steepening in FUCHS and flattening in KC, this difference was no longer present after suture removal. Visual acuity in KC exceeded that in FUCHS before (0.68 vs. 0.60) and even more after suture removal (0.86 vs. 0.60; p < 0.001). CONCLUSIONS: In KC, keratometric astigmatism is not higher than in FUCHS after PKP. After suture removal, graft topography in KC and FUCHS may be expected to regularize and the excessive corneal flattening in FUCHS to normalize in the mid-term.

Published 6 September 2006 in Ophthalmologica, 220(5): 302-6.
Full-text of this article is available online (may require subscription).

© 2005-2008 Astigmatism Research Today. All Rights Reserved.