Combined astigmatic keratotomy and conductive keratoplasty to correct high corneal astigmatism.
OBJECTIVE
To determine the safety, efficacy, and predictability of combined astigmatic keratotomy (AK) and conductive keratoplasty (CK) for treating high corneal astigmatism.


METHODS
University of California-Los Angeles, Los Angeles, California, USA.


METHODS
Retrospective case series.


METHODS
From January 1, 2004, to December 31, 2009, AK and CK were performed in eyes with corneal astigmatism of 5.0 diopters (D) or more after keratoplasty or trauma. The uncorrected (UDVA) and corrected (CDVA) distance visual acuities, spherical equivalent (SE), defocus equivalent, mean astigmatism, efficacy index, and complications were evaluated.


RESULTS
In 11 eyes of 11 patients, the mean UDVA improved from 1.54 logMAR ± 0.50 (SD) preoperatively to 0.69 ± 0.62 logMAR 3 months postoperatively (P < .001) and the mean CDVA from 0.55 ± 0.62 logMAR to 0.12 ± 0.11 logMAR (P = .028). The mean SE and mean defocus equivalent decreased from -1.25 ± 5.06 D to 3.13 ± 3.06 D (P = .15) and from 7.98 ± 4.41 D to 6.97 ± 3.73 D (P = .45), respectively; these changes were not statistically significant. The mean absolute astigmatism decreased from 10.25 ± 4.71 D to 4.31 ± 2.34 D (P < .001). The mean absolute orthogonal and mean oblique astigmatism showed a statistically significant decrease. The efficacy index was 0.82. One case of wound gape after AK required suturing. No infectious keratitis, corneal perforation, or graft rejection occurred.


CONCLUSIONS
Results indicate that combined AK and CK is safe and effective for correcting high corneal astigmatism after surgery or trauma.
From the American Eye Center (Sy), Makati, Manila, Philippines; Houston Eye Associates (Kovoor), Houston, Texas, Jules Stein Eye Institute (Tannan, Deng, Hamilton), David Geffen School of Medicine (Danesh), University of California Los Angeles, Los Angeles, and the Department of Ophthalmology (Choi), Stanford School of Medicine, Stanford, California, USA.
Mary Ellen
ME
Sy
From the American Eye Center (Sy), Makati, Manila, Philippines; Houston Eye Associates (Kovoor), Houston, Texas, Jules Stein Eye Institute (Tannan, Deng, Hamilton), David Geffen School of Medicine (Danesh), University of California Los Angeles, Los Angeles, and the Department of Ophthalmology (Choi), Stanford School of Medicine, Stanford, California, USA.
Timmy A
TA
Kovoor
From the American Eye Center (Sy), Makati, Manila, Philippines; Houston Eye Associates (Kovoor), Houston, Texas, Jules Stein Eye Institute (Tannan, Deng, Hamilton), David Geffen School of Medicine (Danesh), University of California Los Angeles, Los Angeles, and the Department of Ophthalmology (Choi), Stanford School of Medicine, Stanford, California, USA.
Anjali
A
Tannan
From the American Eye Center (Sy), Makati, Manila, Philippines; Houston Eye Associates (Kovoor), Houston, Texas, Jules Stein Eye Institute (Tannan, Deng, Hamilton), David Geffen School of Medicine (Danesh), University of California Los Angeles, Los Angeles, and the Department of Ophthalmology (Choi), Stanford School of Medicine, Stanford, California, USA.
Daniel
D
Choi
From the American Eye Center (Sy), Makati, Manila, Philippines; Houston Eye Associates (Kovoor), Houston, Texas, Jules Stein Eye Institute (Tannan, Deng, Hamilton), David Geffen School of Medicine (Danesh), University of California Los Angeles, Los Angeles, and the Department of Ophthalmology (Choi), Stanford School of Medicine, Stanford, California, USA.
Sophie X
SX
Deng
From the American Eye Center (Sy), Makati, Manila, Philippines; Houston Eye Associates (Kovoor), Houston, Texas, Jules Stein Eye Institute (Tannan, Deng, Hamilton), David Geffen School of Medicine (Danesh), University of California Los Angeles, Los Angeles, and the Department of Ophthalmology (Choi), Stanford School of Medicine, Stanford, California, USA.
Jennifer
J
Danesh
From the American Eye Center (Sy), Makati, Manila, Philippines; Houston Eye Associates (Kovoor), Houston, Texas, Jules Stein Eye Institute (Tannan, Deng, Hamilton), David Geffen School of Medicine (Danesh), University of California Los Angeles, Los Angeles, and the Department of Ophthalmology (Choi), Stanford School of Medicine, Stanford, California, USA. Electronic address: hamilton@jsei.ucla.edu.
D Rex
DR
Hamilton
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001251:Astigmatism / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D003131:Combined Modality Therapy; D003315:Cornea / Q000503:physiopathology; D019781:Corneal Topography; D004599:Electric Stimulation Therapy; D005260:Female; D006801:Humans; D020731:Keratomileusis, Laser In Situ; D015948:Keratoplasty, Penetrating; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012029:Refraction, Ocular / Q000502:physiology; D054140:Refractive Surgical Procedures; D012189:Retrospective Studies; D014792:Visual Acuity / Q000502:physiology