title: Corneal radius of curvature after anterior lamellar versus penetrating keratoplasty.
abstract: BACKGROUND
  Keratoplasty may induce major spherical refractive error related to abnormal corneal radius of curvature (CRC).
  
  
  METHODS
  Two hundred and thirty-eight consecutive eyes of 238 patients with clear graft and at least one postoperative Orbscan examination performed after suture removal (average follow-up time, 86 months) were retrospectively analyzed. Anterior lamellar keratoplasties (ALK group, n = 119) and penetrating keratoplasties (PK group, n = 119) were matched for preoperative diagnosis and lens status.
  
  
  RESULTS
  The average postoperative, suture-out, Orbscan 3-mm CRC was 7.17 mm with a wide 95 % confidence interval [6.26 mm; 8.37 mm]. It was 7.05 mm in the ALK group and 7.31 mm in the PK group (p < 0.01). In the ALK group, this figure was 7.00 mm for oversized grafts and 7.67 mm for non-oversized grafts (p < 0.001). CRC values were significantly lower for eyes with keratoconus (7.00 mm) or stromal scar after infectious keratitis (7.06 mm) compared with stromal scar after trauma (7.74 mm) or stromal dystrophies (8.17 mm). Values were significantly lower for big-bubble ALKs (6.92 mm) and manual dissection-ALKs (7.14 mm) compared with PKs (7.31 mm) and microkeratome-assisted ALKs (7.45 mm). The average Orbscan 3-mm SimK cylinder, irregularity, and refractive power symmetry index were, respectively, 4.7 D/4.8 D/1.9 D for ALKs and 5.2 D/4.8 D/1.8 D for PKs (p = 0.99).
  
  
  CONCLUSIONS
  The CRC is lower after ALK compared with PK, and features important variability. In eyes with ALK, non-oversized grafts result in postoperative CRC close to normal values and corneal diseases associated with stromal thinning and DALK result in lower postoperative CRC.
authors: Centre Hospitalier National d'Ophtalmologie des XV-XX, Pierre & Marie Curie University Paris 06, Clinical Investigation Centre 503, 28 rue de Charenton, 75012, Paris, France, vincent.borderie@upmc.fr.
authors: Vincent M
authors: VM
authors: Borderie
authors: Cristina
authors: C
authors: Georgeon
authors: Marie
authors: M
authors: Borderie
authors: Nacim
authors: N
authors: Bouheraoua
authors: Olivier
authors: O
authors: Touzeau
authors: Laurent
authors: L
authors: Laroche
mesh_terms: D003315:Cornea / Q000473:pathology*; D003316:Corneal Diseases / Q000601:surgery*; D019781:Corneal Topography; D016039:Corneal Transplantation; D006801:Humans; D015948:Keratoplasty, Penetrating; D009929:Organ Size; D012029:Refraction, Ocular / Q000502:physiology*; D012189:Retrospective Studies; D014019:Tissue Donors; D014021:Tissue Preservation