Background: In penetrating keratoplasty adaptation of wound edges, mode of trephination of both donor and patient cornea and last but not least techniques of suture style are the factors determining postoperative astigmatism. A new corneal marking device for keratoplasties and epikeratophakias is introduced. This marker helps the surgeon both to center the trephine and to perform a perfect double running torque antitorque suture.
Methods: The marker has the shape of an 8-bite star. It can be stained and printed on the cornea. The cross hair of the marker has to be right in the optical center. After trephination we fix the graft with temporal single sutures. Then we mark the dried cornea, so that an 8-bite star can be printed on the cornea. Now a first 10-0 running suture is done. The second continuous suture can be set just in between. In our experience it turns out more precisely, if this second running suture is previously marked, too.
Results and conclusions: After 35 perforating keratoplasties performed with this new marking device the mean astigmatism was 2.0 +/- 0.75 dpt (x +/- sx). Only a prospective, randomized study comparing different suture styles with and without star marker can elucidate the definite value of this new surgical instrument.