title: Corneal topography, arcuate keratotomy, and compression sutures for astigmatism after penetrating keratoplasty.
abstract: BACKGROUND
  Twenty (20) patients with post-penetrating keratoplasty (PKP) (21 eyes) and excessive corneal astigmatism were studied using corneal topography to determine placement of arcuate incisions and compression sutures for astigmatism reduction.
  
  
  METHODS
  Keratoplasty wounds and compression sutures were placed asymmetrically based on corneal topography only. Incisions were at the donor-host junction at a depth of 500 microns.
  
  
  RESULTS
  A 56% reduction in corneal astigmatism was accomplished with an average cylinder reduction of 5.3 D. Keratometry readings were reduced in 18 of 20 (90%) of eyes and refractive cylinder was reduced in 15 of 20 (75%) of eyes. Corrected visual acuity improved in 15 of 20 (75%) declined in 15%, and did not change in 10%.
  
  
  CONCLUSIONS
  Visual acuity can be improved by manipulating the astigmatism after penetrating keratoplasty using corneal topography maps to determine placement of arcuate incisions and compression sutures.
authors.affiliation: Department of Ophthalmology, University of Kentucky, Lexington, USA.
authors.forename: B H
authors.initials: BH
authors.lastname: Koffler
authors.forename: V M
authors.initials: VM
authors.lastname: Smith
mesh_terms: D000368:Aged; D001251:Astigmatism / Q000473:pathology / Q000601:surgery*; D003315:Cornea / Q000473:pathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015948:Keratoplasty, Penetrating; D007646:Keratotomy, Radial; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000473:pathology / Q000601:surgery*; D012029:Refraction, Ocular; D013537:Sutures; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology