title: Small-diameter, round, eccentric penetrating keratoplasties and corneal topographic correlation.
abstract: OBJECTIVE
  The purpose of the study is to report the outcome and postoperative topographic analysis of seven patients who underwent small-diameter, round, eccentric penetrating keratoplasty.
  
  
  METHODS
  Seven patients underwent small-diameter, round, eccentric penetrating keratoplasty for a variety of corneal disorders (cataract wound necrosis and dehiscence or fistula, three patients; penetrating keratoplasty wound infection, two patients; corneal rheumatoid melt and perforation, one patient; localized fungal keratitis, one patient). Full-thickness corneal transplants ranged in size from 3.0 to 5.5 mm. The graft wound and sutures spared the visual axis in all cases. Patients were observed for 7 to 42 months (mean, 21 months). All patients had postoperative topographic analysis. One of these also had preoperative analysis.
  
  
  RESULTS
  All grafts tectonically were effective in treating the intended condition. Best-corrected visual acuity was 20/30 or better in the four patients without pre-existing corneal transplants or dry eyes; 20/60 and 5/200 in the patients with previous central penetrating keratoplasties; and 20/40 in the patient with rheumatoid melt. There was no clinically significant regular or irregular astigmatism induced centrally by the eccentric graft in the four patients where visual acuity was 20/30 or better. Irregular astigmatism was noted in the other three patients.
  
  
  CONCLUSIONS
  Small-diameter, eccentric penetrating keratoplasties may be used successfully to treat various peripheral corneal disorders. In some cases, this can be performed without inducing high or irregular astigmatism or both centrally.
authors.affiliation: Division of Ophthalmology, Cleveland Clinic Foundation, OH 44195, USA.
authors.forename: K C
authors.initials: KC
authors.lastname: Chern
authors.forename: D M
authors.initials: DM
authors.lastname: Meisler
authors.forename: S E
authors.initials: SE
authors.lastname: Wilson
authors.forename: M S
authors.initials: MS
authors.lastname: Macsai
authors.forename: R H
authors.initials: RH
authors.lastname: Krasney
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003315:Cornea / Q000473:pathology*; D003316:Corneal Diseases / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D015948:Keratoplasty, Penetrating / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011184:Postoperative Period; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity