Compressive C-shaped lamellar keratoplasty: a surgical alternative for the management of severe astigmatism from peripheral corneal degeneration

Ophthalmology. 2005 Mar;112(3):425-30. doi: 10.1016/j.ophtha.2004.10.033.


Objective: To describe a compressive lamellar surgical technique for treating severe astigmatism in peripheral corneal ectasia.

Design: Retrospective, noncomparative, interventional case series.

Participants: Four eyes of 3 patients with either pellucid or Terrien's marginal corneal degeneration were included in this series.

Methods: C-shaped lamellar keratoplasty using multiple trephines of different sizes, with deliberate undersizing of the donor graft for a controlled compressive effect, was performed on these patients.

Main outcome measures: Visual acuity outcome and refraction were measured at different intervals at up to 40 months of follow-up.

Results: All eyes achieved Snellen visual acuity of 20/40 or better and stable astigmatism ranging from 0 to -2.75 diopter cylinder within 6 months, with no recurrence of corneal thinning or peripheral corneal vascularization.

Conclusions: Compressive C-shaped lamellar keratoplasty is able to reduce severe corneal astigmatism in peripheral corneal ectasia and can result in good visual and refractive outcomes with early visual rehabilitation.

Publication types

  • Case Reports

MeSH terms

  • Astigmatism / etiology
  • Astigmatism / surgery*
  • Cornea / pathology
  • Cornea / surgery*
  • Corneal Dystrophies, Hereditary / complications
  • Corneal Dystrophies, Hereditary / surgery*
  • Corneal Topography
  • Corneal Transplantation / methods*
  • Dilatation, Pathologic
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Refraction, Ocular
  • Retrospective Studies
  • Visual Acuity