Compressive C-shaped lamellar keratoplasty: a surgical alternative for the management of severe astigmatism from peripheral corneal degeneration.
OBJECTIVE
To describe a compressive lamellar surgical technique for treating severe astigmatism in peripheral corneal ectasia.


METHODS
Retrospective, noncomparative, interventional case series.


METHODS
Four eyes of 3 patients with either pellucid or Terrien's marginal corneal degeneration were included in this series.


METHODS
C-shaped lamellar keratoplasty using multiple trephines of different sizes, with deliberate undersizing of the donor graft for a controlled compressive effect, was performed on these patients.


METHODS
Visual acuity outcome and refraction were measured at different intervals at up to 40 months of follow-up.


RESULTS
All eyes achieved Snellen visual acuity of 20/40 or better and stable astigmatism ranging from 0 to -2.75 diopter cylinder within 6 months, with no recurrence of corneal thinning or peripheral corneal vascularization.


CONCLUSIONS
Compressive C-shaped lamellar keratoplasty is able to reduce severe corneal astigmatism in peripheral corneal ectasia and can result in good visual and refractive outcomes with early visual rehabilitation.
Cheng
Ching-Li
CL
Singapore National Eye Centre, Singapore Eye Research Institute, Singapore.
Theng
Julian T S
JT
Tan
Donald T H
DT
D001251:Astigmatism / Q000209:etiology / Q000601:surgery*; D003315:Cornea / Q000473:pathology / Q000601:surgery*; D003317:Corneal Dystrophies, Hereditary / Q000150:complications / Q000601:surgery*; D019781:Corneal Topography; D016039:Corneal Transplantation / Q000379:methods*; D004108:Dilatation, Pathologic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012029:Refraction, Ocular; D012189:Retrospective Studies; D014792:Visual Acuity