Long-term follow-up of astigmatic keratotomy for corneal astigmatism after penetrating keratoplasty.

Autor: Böhringer D; Eye Center, Medical Center, Faculty of Medicine, University of Freiburg, Germany., Dineva N; Department of Optometry, Aalen University of Applied Sciences, Aalen, Germany., Maier P; Eye Center, Medical Center, Faculty of Medicine, University of Freiburg, Germany., Birnbaum F; Eye Hospital, Klinikum Bremen-Mitte, Bremen, Germany., Kirschkamp T; Department of Optometry, Aalen University of Applied Sciences, Aalen, Germany., Reinhard T; Eye Center, Medical Center, Faculty of Medicine, University of Freiburg, Germany., Eberwein P; Eye Center, Medical Center, Faculty of Medicine, University of Freiburg, Germany. philipp.eberwein@uniklinik-freiburg.de.
Jazyk: angličtina
Zdroj: Acta ophthalmologica [Acta Ophthalmol] 2016 Nov; Vol. 94 (7), pp. e607-e611. Date of Electronic Publication: 2016 May 06.
DOI: 10.1111/aos.13061
Abstrakt: Purpose: To report the long-term stability of paired arcuate corneal keratotomies (AKs) in patients with high regular postpenetrating keratoplasty astigmatism.
Methods: Retrospective chart review of best-corrected visual acuity, refraction and keratometric values of 41 eyes with AK between 2003 and 2012.
Results: Magnitude of median target induced astigmatism vector was 9.2 dioptres (Dpt). We reached a median magnitude of surgically induced astigmatism vector of 9.81 Dpt and a median magnitude of difference vector of 5.5 Dpt. In keratometry, we achieved a net median astigmatism reduction by 3.3 Dpt. The average correction index was 1.14, showing a slight overcorrection. Irregularity of keratometric astigmatism increased by 0.6 Dpt, and spherical equivalent changed by 1.75 Dpt. Monocular best spectacle corrected visual acuity increased from preoperatively 20/63 (0.5 logMAR) to 20/40 (0.3 logMAR) postoperatively. Median gain on the ETDRS chart was two lines. Long-term follow-up showed a median keratometric astigmatic increase by 0.3 Dpt per year.
Conclusion: Arcuate corneal keratotomies is a safe and effective method to reduce high regular corneal astigmatism following penetrating keratoplasty but has limited predictability. The long-term follow-up shows an increase of keratometric astigmatism by 0.3 Dpt/year, equalizing the surgical effect after 10 years.
(© 2016 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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