• Postoperative astigmatism is one of the major limitations of penetrating keratoplasty. In an attempt to reduce postkeratoplasty astigmatism, we combined corneal-relaxing incisions with orthogonal compression sutures, guided by the intraoperative use of a ring keratometer. Eleven consecutive patients from a mixed referral population with functionally disabling astigmatism were studied. The average preoperative keratometric cylinder of 11.68 diopters was reduced by 7.95 (±3.03 SD) diopters. Each patient's net keratometric cylinder was reduced. We believe that this technique is safer and more predictable than previously published techniques.
McCartney DL, Whitney CE, Stark WJ, Wong SK, Bernitsky DA. Refractive Keratoplasty for Disabling Astigmatism After Penetrating Keratoplasty. Arch Ophthalmol. 1987;105(7):954-957. doi:10.1001/archopht.1987.01060070090035