Same-size donor corneas for myopic keratoconus.

Abstract

To determine the efficacy of using same-size donor grafts for keratoconus patients with axial myopia. A prospective noncomparative interventional case series was performed on 142 eyes of 136 consecutive keratoconus patients. Penetrating keratoplasty (PKP) was performed by 3 skilled surgeons using the same technique with a single running 10-0 nylon suture. Donor button size was determined by a study protocol, where a same-size donor was used for eyes with an axial length (AXL) longer than 24.50 mm, whereas a 0.25-mm-oversized donor was used for eyes shorter than 24.49 mm. Postoperative spherical equivalent (SE) and incidence of postoperative complications were analyzed. Of the 142 consecutive eyes, 123 eyes were operated according to protocol. The average postoperative SE on last visit was -3.94 +/- 3.21 D, with an average uncorrected visual acuity of 0.28 (0.90 average corrected). Postoperative SE correlated inversely (r = 0.46) with preoperative axial length (AXL) expressed by the equation: SE = -0.15 (AXL)2+6.40 (AXL)-71.82. Graft rejection was observed in 7 eyes (5.7%), and glaucoma in 2 eyes that required surgery. Using same-size donor grafts in keratoconus patients with a long visual axis is a safe and effective procedure in reducing postoperative myopia.