Corneal Compression Sutures for the Reduction of Astigmatism After Penetrating Keratoplasty

Arcuate Relaxing Incisions Guided by Corneal Topography for Postkeratoplasty Astigmatism

“…1Y4 Although a plethora of surgical techniques, including arcuate relaxing incisions with or without orthogonal compressive sutures, wedge resections, compressive sutures, trapezoidal (Ruiz procedure) keratotomy, thermal cautery, transverse incisions (T-cuts), limbus-parallel relaxing incisions, circular incisions, and recently, astigmatic excimer laser ablation have been attempted, most surgeons today will use the arcuate relaxing incision as the primary procedure to minimize excessive regular or irregular astigmatism after penetrating keratoplasty. 2,5Y39 Most studies have demonstrated the unpredictability of results with relaxing incisions. 5,8,11,16,17,19,21,27,28,31,33 No standard technique has been established for this procedure.…”

Prognose von Korneatransplantationen nach Bulbusperforation

“…Durchschnittlich liegt der Wert des Astigmatismus nach einer Keratoplastik zwischen 3 und 6 Dioptrien [6,27,40,41,45,75,79]. Bei 10 % der Keratoplastiken ist dieser Wert zwischen 5,0 und 6,0 Dioptrien, höhere Werte kön-nen beispielsweise bei Keratokonus und Hornhautnarben entstehen [27,30].…”

Long-term results of corneal wedge resections for the correction of high astigmatism

“…Surgical corrections of severe astigmatism by various microsurgical techniques have been described [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15]. The most important are relaxing incisions, with or without compression sutures, and corneal wedge resections.…”

“…The amount of correction, however, is unpredictable [3][4][5][6], and the risk of wound dehiscence, graft instability and corneal perforation must be considered [3][4][5][6]8]. Recently, Limberg et al described the use of compression sutures alone for the reduction of astigmatism after penetrating keratoplasty [ 15]. The astigmatism was reduced by only 4.8 D on average 9 to 12 months after surgery.…”

“…The addition of compression sutures in the fiat axis has been used to augment the effect obtained by relaxing incisions [13,14]. Recently, Limberg et al described the use of compression sutures alone for the reduction of astigmatism after penetrating keratoplasty [15]. A wedge resection comprises the resection of a wedge of tissue inside, encompassing, or outside the graftrecipient scar in the fiat axis, followed by the placement of multiple sutures.…”