title: [Visual acuity and astigmatism after keratoplasty. Differences between the guided trephine system and motor trephine].
abstract: BACKGROUND
  The purpose of this study was to assess the differences in postoperative visual acuity, astigmatism, and selected postoperative complications between a guided trephine system (GTS) and motor trephine after penetrating keratoplasty.
  
  
  METHODS
  In this retrospective analysis 74 patients who had undergone penetrating keratoplasty either by GTS (n = 53) or by motor trephine (Motortrepan) (n = 21) were included. Both patient groups included in this analysis were selected to ensure a homogeneous distribution of preoperative parameters to the greatest possible extent. However, some significant differences in patient selection between the two groups could not be avoided. Patients in the motor trephine group were older (mean age 68.4 years vs 56.4 years; p < 0.01) and had Fuchs' endothelial dystrophy more often (47.6 % vs 26.4 %) and significantly less keratoconus (14.3 % vs 32.1 %).
  
  
  RESULTS
  No significant differences regarding visual acuity outcomes could be found between GTS and Motortrepan. In both patient groups there were no differences in the amount of preoperative astigmatism (1.36 vs. 2.0 dpt., p = 0.39). However, at the time of final corneal suture removal (2.23 vs. 3.5 dpt., p = 0.03) and at a postoperative control 1 year after final suture removal (2.29 vs. 3.85 dpt., p = 0.005) the amount of astigmatism in the motor trephine group was found to be significantly higher.
  
  
  CONCLUSIONS
  In summary penetrating kerastoplasty using the motor trephine was found to result in significantly higher postoperative astigmatism than those performed with the GTS.
authors: Klinik für Augenheilkunde, Universitätsklinikum des Saarlandes, Homburg/Saar. fejzaastrit@hotmail.com
authors: A
authors: A
authors: Fejza
authors: A
authors: A
authors: Schafia
authors: U
authors: U
authors: Löw
authors: K
authors: K
authors: Hille
authors: B
authors: B
authors: Seitz
mesh_terms: D000368:Aged; D001251:Astigmatism / Q000209:etiology* / Q000517:prevention & control; D003316:Corneal Diseases / Q000150:complications / Q000601:surgery*; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D005858:Germany; D006801:Humans; D015948:Keratoplasty, Penetrating / Q000009:adverse effects* / Q000295:instrumentation* / Q000379:methods; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D025321:Surgery, Computer-Assisted / Q000295:instrumentation / Q000379:methods; D016896:Treatment Outcome; D014207:Trephining / Q000009:adverse effects* / Q000295:instrumentation* / Q000379:methods; D014792:Visual Acuity
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