Excimer laser correction of high astigmatism after keratoplasty

J Cataract Refract Surg. 1996 Apr;22(3):313-7. doi: 10.1016/s0886-3350(96)80242-2.


Purpose: To assess the effectiveness of excimer laser correction of high astigmatism after keratoplasty.

Setting: Kiel University Eye Hospital, Kiel, Germany.

Methods: In a prospective study, we treated high astigmatism in 16 patients using a 193 nm excimer laser with a rotating mask system to make a toric ablation. Thirteen patients had postkeratoplasty astigmatism, 3, idiopathic natural astigmatism. Preoperative refractive cylinder ranged from 3.0 to 9.0 diopters (D). Minimum follow-up was 6 months.

Results: Mean uncorrected visual acuity increased by 3.3 lines in 13 patients. Best corrected visual acuity decreased by no more than two lines in 6 patients and improved by at least one line in 6 patients. Mean cylindrical reduction was 2.8 D. Haze was classified from 0.5 to 2.0.

Conclusions: In this study, the excimer laser technique effectively reduced high corneal astigmatism. The main problems incurred were development of a hyperopic shift and, in some patients, an uncertain refractive outcome. Reasons for inadequate correction of postkeratoplasty astigmatism included a slightly decentered mask and irregular astigmatism from the circular scar.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Astigmatism / etiology
  • Astigmatism / surgery*
  • Cornea / pathology
  • Corneal Diseases / surgery
  • Humans
  • Hyperopia / etiology
  • Image Processing, Computer-Assisted
  • Keratoplasty, Penetrating / adverse effects*
  • Lasers, Excimer
  • Middle Aged
  • Photorefractive Keratectomy / methods*
  • Postoperative Complications
  • Prospective Studies
  • Visual Acuity