title: Retrephination keratoplasty for high astigmatism after penetrating keratoplasty.
abstract: OBJECTIVE
  We report preliminary results of a new procedure for correcting high astigmatism after penetrating keratoplasty.
  
  
  METHODS
  The procedure entails full-thickness trephination along the original donor-recipient junction with careful suturing in a combined interrupted and running fashion. Four eyes of four patients with severe astigmatism and myopia after penetrating keratoplasty underwent the procedure.
  
  
  RESULTS
  High preoperative cylinder ranging from 4.50 to 16.00 D (mean 9.00 D) was reduced to 0.50 to 3.50 D (mean 1.90 D) at the last examination (between 3 to 6 months). Spherical equivalent myopia ranging from -2.00 to -10.25 D (mean -4.90 D) was essentially unchanged at plano to -9.00 D (-4.70 D) at the last examination. Overall, there was a mean refractive cylinder reduction of 7.10 D (79%).
  
  
  CONCLUSIONS
  Retrephination after penetrating keratoplasty appears to be an acceptable alternative for correcting high astigmatism, and had only a small effect on the level of myopia.
authors.affiliation: Anheuser-Busch Eye Institute, Department of Ophthalmology, Saint Louis University, MO, USA.
authors.forename: R R
authors.initials: RR
authors.lastname: Krueger
authors.forename: R J
authors.initials: RJ
authors.lastname: Landry
authors.forename: K K
authors.initials: KK
authors.lastname: Assil
authors.forename: D J
authors.initials: DJ
authors.lastname: Schanzlin
mesh_terms: D001251:Astigmatism / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D003315:Cornea / Q000503:physiopathology / Q000601:surgery*; D016039:Corneal Transplantation / Q000379:methods*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D015948:Keratoplasty, Penetrating / Q000009:adverse effects*; D012086:Reoperation; D013536:Suture Techniques; D014792:Visual Acuity