Astigmatism after penetrating keratoplasty using the Krumeich guided trephine system.
BACKGROUND
The use of a suction trephine during penetrating keratoplasty has the potential to reduce trephination errors and astigmatism after suture removal.


METHODS
In this study, we evaluated refractive astigmatism after suture removal in 26 eyes that had penetrating keratoplasty for keratoconus using refraction, keratometry, and videokeratography. Group I (11 eyes) had manual trephination with an open disposable blade of both the donor (8.2 mm) and the recipient (8.0 mm). Group II (10 eyes) had manual trephination with an open disposable blade of the donor (8.2 mm) and Krumeich guided trephine system trephination of the recipient (8.0 mm). Group III (5 eyes) had guided trephination of both the donor (8.0 mm) and the recipient (8.0 mm).


RESULTS
The guided trephine groups II and III demonstrated statistically significant less refractive cylinder when compared to manual trephination group I (p < .01). The mean keratometric cylinder for group I was 6.50 diopters (D) (range, 1.50 to 9.00 D), for group II was 3.00 D (range, 0.50 to 7.00 D), and for group III was 2.55 D (range, 0 to 4.00 D).


CONCLUSIONS
The Krumeich guided trephine system produced less keratometric astigmatism than manual trephination after penetrating keratoplasty for keratoconus.
Manhattan Eye, Ear, and Throat Hospital, New York, NY.
S C
SC
Belmont
J L
JL
Zimm
R L
RL
Storch
A
A
Draga
R C
RC
Troutman
D001251:Astigmatism / Q000209:etiology* / Q000517:prevention & control; D005500:Follow-Up Studies; D006801:Humans; D007640:Keratoconus / Q000601:surgery*; D015948:Keratoplasty, Penetrating / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D013525:Surgical Instruments; D013536:Suture Techniques