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Manual astigmatic keratotomy offers successful treatment of post-keratoplasty astigmatism

Am J Ophthalmol. 2011;151(4):637-643.

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Manual astigmatic keratotomy yielded similar visual results when performed after deep anterior lamellar keratoplasty and after penetrating keratoplasty, a study said.

The prospective, comparative, interventional case series included 44 eyes of 40 consecutive patients who had at least 5 D of astigmatism. Twenty eyes had undergone DALK and 24 eyes had undergone PK procedures for keratoconus.

After 6 months, the mean refractive cylinder decreased 2.74 ± 1.44 D in the DALK group and 3.18 ± 2.96 D in the PK group.

The logMAR uncorrected visual acuity improved from 0.88 ± 0.20 to 0.54 ± 0.26 in the DALK group and from 1.0 ± 0.34 to 0.53 ± 0.26 in the PK group.

In addition, best corrected visual acuity improved from 0.16 ± 0.09 to 0.13 ± 0.08 in the DALK group and from 0.16 ± 0.12 to 0.11 ± 0.08 in the PK group.

The overcorrection rate was 35% in the DALK group and 41.6% in the PK group, and two eyes in the PK group had micro-perforation. However, no graft rejection or infection was observed.

The authors suggested conducting the study again using a femtosecond laser to determine whether better predictability could be achieved.