Three-year clinical outcome after penetrating keratoplaty for keratoconu with the guided trephine ytem Original Reearch Article

PURPOE: To determine the long-term clinical outcome after keratoplaty with the guided trephine ytem in keratoconu eye. METHOD: In a propective tudy, all conecutive cae of penetrating keratoplaty had trephination performed with the guided trephine ytem, with which both donor and recipient cornea are trephined from the epithelial ide with a ame-ized blade. For wound cloure, a double running antitorque uture technique with 10-0 nylon wa ued. Uncorrected and bet-corrected nellen viual acuity, ubjective refraction, and atigmatim by keratometry were evaluated after final uture removal, 2 and 3 year potoperatively. REULT: In the 31 patient (31 eye) enrolled, mean bet-corrected viual acuity improved from 0.72 ± 0.16 (20/30) after final uture removal to 0.88 ± 0.15 (20/25) 3 year potoperatively (P < .001). The mean pherical equivalent increaed from −0.86 ± 2.10 diopter after final uture removal to −2.35 ± 2.65 diopter 3 year potoperatively (P < .001). Mean keratometric atigmatim decreaed from 4.68 ± 1.76 diopter after final uture removal to 3.57 ± 1.37 diopter 3 year potoperatively (P = .001). Furthermore, an increae in mean keratometric level with time (P = .01) wa oberved and aociated with myopic hift (r = −.46, P = .008). CONCLUION: With the guided trephine ytem, we attained favorable viual reult, with prolonged improvement of viual acuity during the entire follow-up period. Our data how low and decreaing degree of corneal atigmatim over time. During the follow-up period, a myopic hift wa found after final uture removal. Neverthele, thi technique of performing ame-ized graft reduce potoperative reidual myopia.