Abstract
"Vertical tilt" of the graft caused by incongruent cut angles, "horizontal torsion" caused by a asymmetric suturing and decentration of the wound seem to be the most important reasons for high and/or irregular postoperative astigmatism and deterioration of visual outcome after penetrating keratoplasty. We studied the time course of qualitative and quantitative topographic criteria after nonmechanical and mechanical trephination in correlation with visual outcome. Fifty patients each (30 keratconus, 20 Fuchs' dystrophies) underwent nonmechanical trephination (excimer laser MEL60, Aesculap-Meditec, Heroldsberg) and mechanical motor-trephination in penetrating keratoplasty. All procedures (7.5 mm trephination diameter in Fuchs, 8.0 mm in keratoconus, double-running 10-0 nylon suture) were done by one surgeon. Pre-, intra- and postoperative treatment were identical. At the follow-up examinations, the keratometric astigmatism, qualitative and quantitative criteria of the automatic videokeratography, visual acuity and refraction were assessed. In addition, vector-corrected astigmatism (Jaffe-model) was evaluated in the postoperative time course, particularly after suture removal. After a mean follow-up of 1.1 +/- 0.8 years, keratomet...Continue Reading
Citations
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