Original Paper

Corneal Curvature after Penetrating Keratoplasty before and after Suture Removal: A Comparison between Keratoconus and Fuchs' Dystrophy
Berthold Seitz^a, Achim Langenbucher^a, Nora Szentmary^b, Gottfried O.H. Naumann<sup>a

a</sup>Department of Ophthalmology, University of Erlangen-Nürnberg, Erlangen, Germany;
^bDepartment of Ophthalmology, Semmelweis University, Budapest, Hungary

Address of Corresponding Author

Ophthalmologica 2006;220:302-306 (DOI: 10.1159/000094619)

  Key Words

• Fuchs' dystrophy
• Keratoconus
• Postkeratoplasty outcome
• Visual acuity
• Astigmatism
• Central corneal power
• Topographic regularity
• Corneal curvature

  Abstract

Purpose: To assess the differences concerning corneal curvature and visual acuity after penetrating keratoplasty (PKP) comparing keratoconus (KC) and Fuchs' dystrophy (FUCHS). Methods: Inclusion criteria for this prospective, comparative, interventional study were: (1) one surgeon, (2) central round nonmechanical excimer laser PKP without previous surgery, (3) FUCHS (n = 35) or KC (n = 52), (4) standardized graft size (7.5-8.0 mm) and technique, 16-bite double running cross-stitch suture. In 69% of FUCHS, a triple procedure was performed. The main outcome measures were: keratometric astigmatism, surface regularity index, surface asymmetry index, keratometric central corneal power and best-corrected visual acuity before (1.2 ± 0.4 years) and after suture removal (1.8 ± 0.6 years). Results: Astigmatism did not differ significantly between KC and FUCHS (p > 0.1) before (3.3 dpt vs. 3.5 dpt median) and after suture removal (2.5 dpt vs. 3.0 dpt). Surface regularity index and surface asymmetry index were significantly higher in FUCHS than in KC (p < 0.001) at both time stages. Central power was significantly greater in KC than in FUCHS (p < 0.001) with sutures in place. Due to a significant steepening in FUCHS and flattening in KC, this difference was no longer present after suture removal. Visual acuity in KC exceeded that in FUCHS before (0.68 vs. 0.60) and even more after suture removal (0.86 vs. 0.60; p < 0.001). Conclusions: In KC, keratometric astigmatism is not higher than in FUCHS after PKP. After suture removal, graft topography in KC and FUCHS may be expected to regularize and the excessive corneal flattening in FUCHS to normalize in the mid-term.

Copyright © 2006 S. Karger AG, Basel

  Author Contacts

Prof. Dr. med. Berthold Seitz
Klinikum für Augenheilkunde, Universitätsklinikum des Saarlandes
Kirrberger Strasse, Gebäude 22, DE-66421 Homburg/Saar (Germany)
Tel. +49 6841 162 2388, Fax +49 6841 162 2400
E-Mail berthold.seitz@uniklinikum-saarland.de

  Article Information

Received: October 6, 2005
Accepted after revision: January 13, 2006
Number of Print Pages : 5
Number of Figures : 0, Number of Tables : 2, Number of References : 23