title: Limbal wedge resection at the time of intraocular lens surgery for reducing postkeratoplasty astigmatism.
abstract: Thirteen limbal wedge resections performed to reduce postkeratoplasty astigmatism in patients undergoing secondary intraocular lens placement were reviewed. Eleven of the 13 procedures reduced preoperative astigmatism 3.12 diopters (+/- 1.77 D; range, 0.50 D to 6.25 D). The average follow-up time was 17 months (range, 4 to 36 months). The average flat/steep ratio was 1.19 (+/- 0.96), indicating approximately equal degrees of corneal flattening and steepening. Average central corneal keratometric values steepened 0.47 D, with a range of 0.56 D of flattening to 2.41 D of steepening. Keratometric values were stable by 4 months in most patients. All patients except one with amblyopia had a corrected visual acuity of 20/60 or better. A dellen formation developed in one case, but it caused no permanent negative visual complications. As generally found in previous studies, each 0.1-mm wedge-width resected induced 1 D of astigmatic correction. Limbal wedge resection in conjunction with intraocular lens implantation can safely and effectively reduce astigmatism following penetrating keratoplasty.
authors.affiliation: Virginia Mason Clinic, Seattle, WA 98111.
authors.forename: H S
authors.initials: HS
authors.lastname: Geggel
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001251:Astigmatism / Q000209:etiology / Q000601:surgery*; D002387:Cataract Extraction; D003315:Cornea / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015948:Keratoplasty, Penetrating / Q000009:adverse effects*; D007910:Lenses, Intraocular; D008297:Male; D008722:Methods; D008875:Middle Aged; D011300:Preoperative Care; D012590:Sclera / Q000601:surgery; D014792:Visual Acuity