Influence of surgical factors on postoperative corneal refractive power and astigmatism after keratoplasty

Abstract

SettingsThe study was conducted in Faculty of Medicine, Alexandria University, Egypt.PurposeThe aim of the study was to analyze the influence of various surgical factors on the postoperative corneal refractive power and astigmatism after keratoplasty in eyes with corneal diseases.Patients and MethodsThis was a retrospective study on 100 eyes with clear grafts 6 months following keratoplasty; the influence of different surgical factors (technique of keratoplasty, type of suturing, size of trephination) on the postoperative corneal refractive power and astigmatism was analyzed. All included patients signed informed consent.ResultsAround 70% of the cases of the four subgroups had keratoconus. The flattest 6 months postoperative keratometric reading was the penetrating keratoplasty (PK) with interrupted sutures subgroup with mean ± SD 43.90 ± 3.09 D. The steepest was the deep anterior lamellar keratoplasty (DALK) with double-running sutures subgroup with mean ± SD 45.30 ± 1.70 D. The highest 6 months postoperative astigmatism was the PK with interrupted sutures subgroup with mean ± SD 7.15 ± 1.95 D. The lowest was the PK with double-running sutures subgroup with mean ± SD 2.36 ± 1.15 D.ConclusionInterrupted sutures resulted in significantly higher postoperative astigmatism in both PK and DALK before suture removal. Double-running sutures resulted in acceptable postoperative astigmatism even before suture removal. DALK resulted in higher postoperative astigmatism and steeper grafts than PK.