Outcomes of Augmented Relaxing Incisions for Postpenetrating Keratoplasty Astigmatism in Keratoconus
PURPOSE:To determine the outcomes of augmented relaxing incisions (relaxing incisions and counter-quadrant compression sutures) as graft refractive surgery (GRS) in keratoconic eyes. PATIENTS AND METHODS:This interventional case series included keratoconic eyes undergoing GRS for intolerable amounts...
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| Veröffentlicht in: | Cornea 2009-04, Vol.28 (3), p.280-284 |
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| creator | Javadi, Mohammad A Feizi, Sepehr Yazdani, Shahin Sharifi, Ali Sajjadi, Hamid |
| description | PURPOSE:To determine the outcomes of augmented relaxing incisions (relaxing incisions and counter-quadrant compression sutures) as graft refractive surgery (GRS) in keratoconic eyes.
PATIENTS AND METHODS:This interventional case series included keratoconic eyes undergoing GRS for intolerable amounts of postpenetrating keratoplasty (PKP) astigmatism. Relaxing incisions were made in the graft-host interface down to Descemet membrane on both sides of the steepest meridian. Interrupted 10-0 nylon compression sutures were added in the opposite meridian to overcorrect astigmatism. Selective suture removal was initiated after 3-6 weeks to achieve tolerable amounts of astigmatism. Best-corrected visual acuity and refractive and keratometric astigmatisms were compared before and after the operation using simple subtraction and vector analysis methods.
RESULTS:Overall, 77 eyes of 77 patients including 51 (66.2%) male and 26 (33.8%) female subjects with mean age of 30.0 ± 10.2 years at the time of PKP were studied. Average follow-up was 61.5 ± 33.5 months after PKP and 40.8 ± 29.3 months after GRS. Mean best-corrected visual acuity improved from 0.31 ± 0.26 logMAR (20/40) before GRS to 0.18 ± 0.12 logMAR (20/30) postoperatively (P < 0.001). Mean preoperative and postoperative values for refractive astigmatism, keratometric astigmatism, and spherical equivalent refractive error were 6.8 ± 1.4 and 3.9 ± 1.6 diopters (D) (P < 0.001), 7.9 ± 1.9 and 4.5 ± 2.2 D (P < 0.001), and −2.0 ± 2.9 and −3.24 ± 2.8 D (P < 0.001), respectively. Vector analysis demonstrated that refractive and keratometric astigmatisms were reduced by 4.8 and 5.9 D, respectively.
CONCLUSIONS:GRS using augmented relaxing incisions reduces post-PKP astigmatism in keratoconic eyes; however, it causes a slight myopic shift. |
| doi_str_mv | 10.1097/ICO.0b013e3181875496 |
| format | Article |
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PATIENTS AND METHODS:This interventional case series included keratoconic eyes undergoing GRS for intolerable amounts of postpenetrating keratoplasty (PKP) astigmatism. Relaxing incisions were made in the graft-host interface down to Descemet membrane on both sides of the steepest meridian. Interrupted 10-0 nylon compression sutures were added in the opposite meridian to overcorrect astigmatism. Selective suture removal was initiated after 3-6 weeks to achieve tolerable amounts of astigmatism. Best-corrected visual acuity and refractive and keratometric astigmatisms were compared before and after the operation using simple subtraction and vector analysis methods.
RESULTS:Overall, 77 eyes of 77 patients including 51 (66.2%) male and 26 (33.8%) female subjects with mean age of 30.0 ± 10.2 years at the time of PKP were studied. Average follow-up was 61.5 ± 33.5 months after PKP and 40.8 ± 29.3 months after GRS. Mean best-corrected visual acuity improved from 0.31 ± 0.26 logMAR (20/40) before GRS to 0.18 ± 0.12 logMAR (20/30) postoperatively (P < 0.001). Mean preoperative and postoperative values for refractive astigmatism, keratometric astigmatism, and spherical equivalent refractive error were 6.8 ± 1.4 and 3.9 ± 1.6 diopters (D) (P < 0.001), 7.9 ± 1.9 and 4.5 ± 2.2 D (P < 0.001), and −2.0 ± 2.9 and −3.24 ± 2.8 D (P < 0.001), respectively. Vector analysis demonstrated that refractive and keratometric astigmatisms were reduced by 4.8 and 5.9 D, respectively.
CONCLUSIONS:GRS using augmented relaxing incisions reduces post-PKP astigmatism in keratoconic eyes; however, it causes a slight myopic shift.</description><identifier>ISSN: 0277-3740</identifier><identifier>EISSN: 1536-4798</identifier><identifier>DOI: 10.1097/ICO.0b013e3181875496</identifier><identifier>PMID: 19387228</identifier><language>eng</language><publisher>United States: Copyright Wolters Kluwer Health, Inc. All rights reserved</publisher><subject>Adolescent ; Adult ; Astigmatism - etiology ; Astigmatism - surgery ; Cornea - surgery ; Female ; Follow-Up Studies ; Humans ; Keratoconus - surgery ; Keratoplasty, Penetrating - adverse effects ; Male ; Middle Aged ; Postoperative Complications ; Refractive Surgical Procedures ; Suture Techniques ; Treatment Outcome ; Visual Acuity - physiology ; Young Adult</subject><ispartof>Cornea, 2009-04, Vol.28 (3), p.280-284</ispartof><rights>Copyright © 2009 Wolters Kluwer Health, Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3506-f62b1be24403297fbbec7045cbd3807f8fbac327e5ec71f36a938dada67c3de53</citedby><cites>FETCH-LOGICAL-c3506-f62b1be24403297fbbec7045cbd3807f8fbac327e5ec71f36a938dada67c3de53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19387228$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Javadi, Mohammad A</creatorcontrib><creatorcontrib>Feizi, Sepehr</creatorcontrib><creatorcontrib>Yazdani, Shahin</creatorcontrib><creatorcontrib>Sharifi, Ali</creatorcontrib><creatorcontrib>Sajjadi, Hamid</creatorcontrib><title>Outcomes of Augmented Relaxing Incisions for Postpenetrating Keratoplasty Astigmatism in Keratoconus</title><title>Cornea</title><addtitle>Cornea</addtitle><description>PURPOSE:To determine the outcomes of augmented relaxing incisions (relaxing incisions and counter-quadrant compression sutures) as graft refractive surgery (GRS) in keratoconic eyes.
PATIENTS AND METHODS:This interventional case series included keratoconic eyes undergoing GRS for intolerable amounts of postpenetrating keratoplasty (PKP) astigmatism. Relaxing incisions were made in the graft-host interface down to Descemet membrane on both sides of the steepest meridian. Interrupted 10-0 nylon compression sutures were added in the opposite meridian to overcorrect astigmatism. Selective suture removal was initiated after 3-6 weeks to achieve tolerable amounts of astigmatism. Best-corrected visual acuity and refractive and keratometric astigmatisms were compared before and after the operation using simple subtraction and vector analysis methods.
RESULTS:Overall, 77 eyes of 77 patients including 51 (66.2%) male and 26 (33.8%) female subjects with mean age of 30.0 ± 10.2 years at the time of PKP were studied. Average follow-up was 61.5 ± 33.5 months after PKP and 40.8 ± 29.3 months after GRS. Mean best-corrected visual acuity improved from 0.31 ± 0.26 logMAR (20/40) before GRS to 0.18 ± 0.12 logMAR (20/30) postoperatively (P < 0.001). Mean preoperative and postoperative values for refractive astigmatism, keratometric astigmatism, and spherical equivalent refractive error were 6.8 ± 1.4 and 3.9 ± 1.6 diopters (D) (P < 0.001), 7.9 ± 1.9 and 4.5 ± 2.2 D (P < 0.001), and −2.0 ± 2.9 and −3.24 ± 2.8 D (P < 0.001), respectively. Vector analysis demonstrated that refractive and keratometric astigmatisms were reduced by 4.8 and 5.9 D, respectively.
CONCLUSIONS:GRS using augmented relaxing incisions reduces post-PKP astigmatism in keratoconic eyes; however, it causes a slight myopic shift.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Astigmatism - etiology</subject><subject>Astigmatism - surgery</subject><subject>Cornea - surgery</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Keratoconus - surgery</subject><subject>Keratoplasty, Penetrating - adverse effects</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Postoperative Complications</subject><subject>Refractive Surgical Procedures</subject><subject>Suture Techniques</subject><subject>Treatment Outcome</subject><subject>Visual Acuity - physiology</subject><subject>Young Adult</subject><issn>0277-3740</issn><issn>1536-4798</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkFtr3DAQhUVoSbZJ_kEIfuqb05FkS_bjsvSyNLCltM9ClkcbJ7a11cik-ffVkoVAn-ZyZg6cj7EbDnccWv1pu9ndQQdcouQNb3RdteqMrXgtVVnptnnHViC0LqWu4IJ9IHoEAK2VOGcXvJWNFqJZsX63JBcmpCL4Yr3sJ5wT9sVPHO3fYd4X29kNNISZCh9i8SNQOuCMKdp0VL9jbsJhtJReijWlYT9lgaZimE-aC_NCV-y9tyPh9alest9fPv_afCvvd1-3m_V96WQNqvRKdLxDUVUgRat916HTUNWu62UD2je-s04KjXXecy-VzTF621ulneyxlpfs46vvIYY_C1Iy00AOx9HOGBYySvOaA9f5sHo9dDEQRfTmEIfJxhfDwRzpmkzX_E83v92e_Jduwv7t6YTzzfc5jAkjPY3LM0bzgHZMDybzz8GEKgVAC1WeyuNKyX9JOYhb</recordid><startdate>200904</startdate><enddate>200904</enddate><creator>Javadi, Mohammad A</creator><creator>Feizi, Sepehr</creator><creator>Yazdani, Shahin</creator><creator>Sharifi, Ali</creator><creator>Sajjadi, Hamid</creator><general>Copyright Wolters Kluwer Health, Inc. All rights reserved</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200904</creationdate><title>Outcomes of Augmented Relaxing Incisions for Postpenetrating Keratoplasty Astigmatism in Keratoconus</title><author>Javadi, Mohammad A ; Feizi, Sepehr ; Yazdani, Shahin ; Sharifi, Ali ; Sajjadi, Hamid</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3506-f62b1be24403297fbbec7045cbd3807f8fbac327e5ec71f36a938dada67c3de53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Astigmatism - etiology</topic><topic>Astigmatism - surgery</topic><topic>Cornea - surgery</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Keratoconus - surgery</topic><topic>Keratoplasty, Penetrating - adverse effects</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Postoperative Complications</topic><topic>Refractive Surgical Procedures</topic><topic>Suture Techniques</topic><topic>Treatment Outcome</topic><topic>Visual Acuity - physiology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Javadi, Mohammad A</creatorcontrib><creatorcontrib>Feizi, Sepehr</creatorcontrib><creatorcontrib>Yazdani, Shahin</creatorcontrib><creatorcontrib>Sharifi, Ali</creatorcontrib><creatorcontrib>Sajjadi, Hamid</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Cornea</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Javadi, Mohammad A</au><au>Feizi, Sepehr</au><au>Yazdani, Shahin</au><au>Sharifi, Ali</au><au>Sajjadi, Hamid</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Outcomes of Augmented Relaxing Incisions for Postpenetrating Keratoplasty Astigmatism in Keratoconus</atitle><jtitle>Cornea</jtitle><addtitle>Cornea</addtitle><date>2009-04</date><risdate>2009</risdate><volume>28</volume><issue>3</issue><spage>280</spage><epage>284</epage><pages>280-284</pages><issn>0277-3740</issn><eissn>1536-4798</eissn><abstract>PURPOSE:To determine the outcomes of augmented relaxing incisions (relaxing incisions and counter-quadrant compression sutures) as graft refractive surgery (GRS) in keratoconic eyes.
PATIENTS AND METHODS:This interventional case series included keratoconic eyes undergoing GRS for intolerable amounts of postpenetrating keratoplasty (PKP) astigmatism. Relaxing incisions were made in the graft-host interface down to Descemet membrane on both sides of the steepest meridian. Interrupted 10-0 nylon compression sutures were added in the opposite meridian to overcorrect astigmatism. Selective suture removal was initiated after 3-6 weeks to achieve tolerable amounts of astigmatism. Best-corrected visual acuity and refractive and keratometric astigmatisms were compared before and after the operation using simple subtraction and vector analysis methods.
RESULTS:Overall, 77 eyes of 77 patients including 51 (66.2%) male and 26 (33.8%) female subjects with mean age of 30.0 ± 10.2 years at the time of PKP were studied. Average follow-up was 61.5 ± 33.5 months after PKP and 40.8 ± 29.3 months after GRS. Mean best-corrected visual acuity improved from 0.31 ± 0.26 logMAR (20/40) before GRS to 0.18 ± 0.12 logMAR (20/30) postoperatively (P < 0.001). Mean preoperative and postoperative values for refractive astigmatism, keratometric astigmatism, and spherical equivalent refractive error were 6.8 ± 1.4 and 3.9 ± 1.6 diopters (D) (P < 0.001), 7.9 ± 1.9 and 4.5 ± 2.2 D (P < 0.001), and −2.0 ± 2.9 and −3.24 ± 2.8 D (P < 0.001), respectively. Vector analysis demonstrated that refractive and keratometric astigmatisms were reduced by 4.8 and 5.9 D, respectively.
CONCLUSIONS:GRS using augmented relaxing incisions reduces post-PKP astigmatism in keratoconic eyes; however, it causes a slight myopic shift.</abstract><cop>United States</cop><pub>Copyright Wolters Kluwer Health, Inc. All rights reserved</pub><pmid>19387228</pmid><doi>10.1097/ICO.0b013e3181875496</doi><tpages>5</tpages></addata></record> |
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| source | MEDLINE; Journals@Ovid Complete |
| subjects | Adolescent Adult Astigmatism - etiology Astigmatism - surgery Cornea - surgery Female Follow-Up Studies Humans Keratoconus - surgery Keratoplasty, Penetrating - adverse effects Male Middle Aged Postoperative Complications Refractive Surgical Procedures Suture Techniques Treatment Outcome Visual Acuity - physiology Young Adult |
| title | Outcomes of Augmented Relaxing Incisions for Postpenetrating Keratoplasty Astigmatism in Keratoconus |
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