title: Compressive C-shaped lamellar keratoplasty: a surgical alternative for the management of severe astigmatism from peripheral corneal degeneration.
abstract: 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.
authors.affiliation: Singapore National Eye Centre, Singapore Eye Research Institute, Singapore.
authors.forename: Ching-Li
authors.initials: CL
authors.lastname: Cheng
authors.forename: Julian T S
authors.initials: JT
authors.lastname: Theng
authors.forename: Donald T H
authors.initials: DT
authors.lastname: Tan
mesh_terms: 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