[Long-term refractive and topographic changes after penetrating keratoplasty].
OBJECTIVE
To analyze long-term refractive and videokeratoscopic changes after penetrating keratoplasty.


METHODS
Forty eyes of 40 patients (26 keratoconus) with a clear corneal graft and no other ocular disease were examined after all sutures were removed, respectively at 22.0+/-7.3 months and 50.5+/-13.6 months after keratoplasty. All of the eyes were examined using videokeratography (EyeSys 2000) and ultrasonic pachymetry. Changes in subjective refraction, best spectacle-corrected visual acuity (LogMAR units), topography, and central corneal thickness between both exams were recorded.


RESULTS
Visual acuity increased by an average of 0.41 lines +/-0.24 (p<0.001) between both exams, whereas no significant change in refractive astigmatism and videokeratoscopy (i.e., power, pattern, and indices) was observed. Central corneal thickness significantly increased from 545+/-36 micro m to 574+/-40 micro m (p<0.001). Change in best spectacle-corrected visual acuity significantly correlated with delay between the exams (r(s)=+0.34, p=0.03), whereas change in refractive astigmatism, topographic indices, and topographic patterns did not significantly correlate with delay.


CONCLUSIONS
After penetrating keratoplasty, visual acuity improves long after surgery, whereas refraction and corneal surface regularity show no significant modification. This improvement in visual acuity, not explained by current techniques, may be due to an increase in graft transparency.
Touzeau
O
O
Pôle Saint Antoine, CHNO des Quinze-Vingts, 28, rue de Charenton, 75571 Paris Cedex 12. touzeau@quinze-vingts.fr
Allouch
C
C
Borderie
V
V
Bourcier
T
T
Scheer
S
S
Laroche
L
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003315:Cornea / Q000033:anatomy & histology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015948:Keratoplasty, Penetrating / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012029:Refraction, Ocular; D013997:Time Factors; D014792:Visual Acuity / Q000502:physiology*