gms | German Medical Science

102. Jahrestagung der DOG

Deutsche Ophthalmologische Gesellschaft e. V.

23. bis 26.09.2004, Berlin

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Corneal first-surface aberration analysis of biomechanical effects of astigmatic keratotomy and a microkeratome cut after penetrating keratoplasty

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  • corresponding author C. Meltendorf - Johann Wolfgang Goethe University, Department of Ophthalmology, Frankfurt am Main
  • J. Bühren - Johann Wolfgang Goethe University, Department of Ophthalmology, Frankfurt am Main
  • T. Kohnen - Johann Wolfgang Goethe University, Department of Ophthalmology, Frankfurt am Main

Evidenzbasierte Medizin - Anspruch und Wirklichkeit. 102. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft. Berlin, 23.-26.09.2004. Düsseldorf, Köln: German Medical Science; 2004. Doc04dogP 040

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dog2004/04dog531.shtml

Published: September 22, 2004

© 2004 Meltendorf et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Objective

A 35-year-old male patient with high astigmatism following penetrating keratoplasty (PK) for keratokonus applied for LASIK to reduce his high astigmatism in his right eye.

Methods

Astigmatic keratotomy (AK) was performed. To correct the residual refractive error after AK, a two-step LASIK approach was planned. Three months after AK, the cut was performed without any complications with the Hansatome™. We did not perform any excimer laser ablation as the patient was happy with the result and refused further treatment.

Results

AK led to a dramatic decrease of astigmatism while corneal higher order aberrations (HOA) increased. One day after the microkeratome cut, a decrease of 2.75 diopters of spherical equivalent (SE) was noted. While lower-order and spherical aberrations were only affected marginally, a marked decrease in coma and other HOA could be observed. One month after the cut, the spherical equivalent was unchanged.

Conclusions

The present report shows that AK cuts can induce higher order corneal aberrations. Moreover, a single microkeratome cut performed in corneal grafts could have strong biomechanical effects, both on lower- and on higher-order aberrations. If LASIK is planned after PK, a two-step approach is recommended to anticipate biomechanical effects to avoid over- or undercorrection.