Influence of Surgical Factors on Postoperative Corneal Refractive Power and Astigmatism after Keratoplasty
Mohamed Bahgat Goweida, FRCS, MD, Hany Ahmed Helaly, MD.
Lecturer of Ophthalmology, Faculty of Medicine, Alexandria University
Settings: Faculty of Medicine, Alexandria University, Egypt.
Purpose: To analyze the influence of various surgical factors on the post-operative corneal refractive power and astigmatism after keratoplasty in eyes with corneal diseases.
Methods: Retrospective study of 100 eyes with clear grafts six months following keratoplasty, the influence of different surgical factors (technique of keratoplasty, type of suturing, size of trephination) on the post-operative corneal refractive power and astigmatism was analyzed. All included patients signed an informed consent.
Results: Around 70% of the cases of the four subgroups had keratoconus. The flattest 6 months postoperative keratometric readings was the penetrating keratoplasty (PK) with interrupted sutures subgroup with mean 43.90 + 3.09 D. The steepest was the deep anterior lamellar keratoplasty (DALK) with double running sutures subgroup with mean 45.30 + 1.70 D. The highest 6 months postoperative astigmatism was the PK with interrupted sutures subgroup with mean 7.15 + 1.95 D. The lowest was the PK with double running sutures subgroup with mean 2.36 + 1.15 D.
Conclusion: Interrupted sutures resulted in significantly higher postoperative astigmatism in both PK and DALK before suture removal.
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2. Anesthetic cornea that may result from acoustic neuroma surgery, surgery for trigeminal neuralgia, birth defects such as dysautonomia and Seckle’s syndrome, herpes simplex/zoster of the cornea, or diabetes.
Results: The study included 40 eyes of 21 patients. All patients completed at least 6 months
Post-cataract endophthalmitis is a rare but serious complication.1 Recent studies show a rate of postoperative endophthalmitis after cataract surgery of 0.04% to 0.29%.2-4 However, it remains the most important concern for surgeons, because it can have devastating consequences on vision.5 It is recently reported that 9% of patients with endophthalmitis have a poor ocular prognosis (visual acuity <20/100).6
Keratitis is an inflammation of the cornea that is sometimes caused by an infection, which includes bacteria, viruses, fungi, or parasites. Keratitis can be caused by wearing contact lenses too long or other noninfectious diseases. Some other symptoms of keratitis are redness in your eye or pain, excess tears or other discharge from the eye and blurred vision or a decreased in vision.
Eye tests usually consist of visual acuity test, which includes Snellen chart reading ( (you are supposed to read letters of different sizes, from largest in the top to smallest in the bottom line). Afterwards, more profound tests are performed, so that problem’s severity can be thoroughly observed. In accordance with results, corrective lenses will be prescribed. During eye testing, optometrist will be evaluating all three aspects of your
The model also incorporated the cost of glaucoma surgery and vitrectomies, which were also reported in the FAME studies. The model considered AEs from intravitreal injections such as endophthalmitis and retinal detachments. The frequency of these events was assumed to be independent of treatment received, and incidence rates were calculated from pooled data from all patients enrolled in the FAME trials. The evaluation did not consider traumatic lens injury and vitreous hemorrhage because it could not be determined if these events were due to the treatment received or the underlying diabetes.
In this work, all the eyes had IOP above 21mmHg on maximally tolerated anti-glaucoma medications. The mean preoperative IOP was insignificantly different between the ologen group and MMC, while mean postoperative IOP was significantly lower in the MMC group on the first postoperative day (p=0.007), and at 1 week (p=0.039). At 1, 3 and 6 months, there was no significant difference between both groups, while 1 year postoperatively it was significantly lower in the ologen group (p=0.005). And there was a significant drop in mean IOP at each follow up period in each group (p<0.001).
Secondary cataract. Cataracts can also be result of a surgery of other eye problems like glaucoma. It can also be a result of other health problems like diabetes.
Low regular astigmatism can be corrected with femtosecond laser-assisted astigmatic keratotomies, whereas irregular astigmatism necessitates customized laser ablation. If the choice is for corneal procedure, the cornea is carefully evaluated to choose between LASIK and PRK. LASIK is used in grafts with adequate thickness and provides faster visual recovery with lesser corneal haze when compared to PRK. However, it carries higher risk of flap-related complications and graft-host junction dehiscence. On the other hand, PRK can be used in thinner superficially opaque grafts but is associated with increased risk of postoperative haze and
The day after surgery you’ll also be permitted to shower (avoid getting soap or water in your eyes), drive short distances (if it’s confirmed you have adequate vision), work on a computer or watch TV (permitted you keep your eyes lubricated), wear facial makeup (no eye makeup), and lift objects weighing less than 50 lbs.
During the surgery, your doctor may be able to insert a new lens that corrects any vision problems you have such as being farsighted or nearsighted. Then, once you've healed from your surgery, the cloudiness will be gone and your vision might be improved enough to allow you to go without glasses. Deciding on the right time to have the laser surgery depends on different variables. If your cataracts grow slowly, you may be able to put off the surgery for a long time. However, it isn't worth postponing the procedure if your vision is impaired to the point where it affects your quality of
You should expect to experience blurry vision for a short time following your lower eyelid surgery. The swelling that occurs can cause a temporary distortion of the cornea, which leads to blurry vision; in addition, ointments used during the surgical procedure or those prescribed for use at night can cause blurriness.