title: [Refractive and topographic changes of ipsilateral rotational autokeratoplasty with a crescent-shape 0.5 mm resection of the inferior cornea in keratoconus after a 24 months follow-up].
abstract: BACKGROUND
  Ipsilateral rotational penetrating autokeratoplasty technique may be an alternative to minimize the problem of long waiting lists for transplantation due to keratoconus.
  
  
  OBJECTIVE
  To report the visual outcomes in keratoconus patients after ipsilateral rotational penetrating autokeratoplasty technique (IRPAK) associated with a crescent-shape resection of 0.5 mm of the inferior cornea.
  
  
  METHODS
  According to a prospective, longitudinal, interventional, analytic study, the authors investigated the visual results of 15 patients (18 eyes) with keratoconus, who underwent an ipsilateral rotational penetrating autokeratoplasty, by two coincident trepanations superiorly and with a difference of 0.5 mm inferiorly. After resection of this corneal crescent, a 180° rotation of the corneal disk was performed, which was fixed with 24 sutures diametrically opposed. The patients were followed-up for a period of 24 months.
  
  
  RESULTS
  Comparing data of the first and second postoperative years to preoperative data, there were: significant improvements in visual acuity, vision lines and spherical equivalent; reduction of topographic astigmatism and maximum and mean corneal curvatures. There was also a decrease in corneal thickness associated to a reduction of corneal endothelial cell count.
  
  
  CONCLUSIONS
  There was an improvement of ophthalmologic parameters 6, 12 and 24 months after ipsilateral rotational penetrating autokeratoplasty associated with a crescent-shape resection of 0.5 mm of the inferior cornea, but along the follow-up there was reduction of visual acuity with increased astigmatism.
authors.affiliation: Departamento de Córnea e Doenças Externas, Hospital da Visão, Recife, PE, Brazil. fernandojmcunha@uol.com.br
authors.forename: Fernando J M
authors.initials: FJ
authors.lastname: Cunha
authors.forename: Wagner
authors.initials: W
authors.lastname: Lira
authors.forename: Carlos Teixeira
authors.initials: CT
authors.lastname: Brandt
mesh_terms: D000293:Adolescent; D000328:Adult; D003315:Cornea / Q000503:physiopathology / Q000601:surgery*; D019781:Corneal Topography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007640:Keratoconus / Q000503:physiopathology / Q000601:surgery*; D015948:Keratoplasty, Penetrating / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012029:Refraction, Ocular / Q000502:physiology; D012399:Rotation; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult