[Astigmatism-oriented perforating keratoplasty. A possibility for minimizing postoperative astigmatism?].
BACKGROUND
This pilot study examined whether astigmatism of donor corneas can be evaluated postmortem, and whether there is an effect on the astigmatism following keratoplasty.


METHODS
The corneoscleral rims of donors were marked after measurement by a hand keratometer in the 12 o'clock position. We examined 38 patients after penetrating keratoplasty and divided them into three groups. The 12 o'clock position of the donor cornea was fixed in the same position as the recipient (group A, n = 12), or the donor corneas were transplanted with the axis in opposition to the axis of the recipient (group B, n = 12) or in the same orientation (group C, n = 14). Development of postoperative astigmatism was compared with controls (group D, n = 40).


RESULTS
In group B we found a new orientation of the astigmatism axis within 2-4 months; in group C the axis maintained the original orientation of the recipient. Mean postoperative astigmatism was 3.5 +/- 1.5 dpt in group A, 2.1 +/- 1.3 dpt in group B, 5.8 +/- 1.6 dpt in group C, and 3.4 +/- 1.5 dpt in group D. After suture removal the axis orientation persisted in all groups.


CONCLUSIONS
This study shows the possibility of evaluating corneal astigmatism in donor eyes. The astigmatism of the donor cornea itself directly influences the postoperative axis of astigmatism in recipient eyes. Astigmatism after corneal grafting can be reduced by orienting the donor astigmatism against the axis of the recipient.
Grütters
G
G
Klinik für Ophthalmologie an der Christian-Albrechts-Universität Kiel, Hegewischstrasse 2, 24105 Kiel. ggruetters@ophthalmol.uni-kiel.de
Reichelt
J A
JA
Nölle
B
B
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001251:Astigmatism / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D019781:Corneal Topography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015948:Keratoplasty, Penetrating; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011183:Postoperative Complications / Q000175:diagnosis* / Q000473:pathology; D012029:Refraction, Ocular; D014019:Tissue Donors