Surgical correction of high postkeratoplasty astigmatism. Relaxing incisions vs wedge resection
J. H. Krachmer and R. E. Fenzl
Improved techniques and procedures have resulted in a higher rate of clear
grafts after penetrating keratoplasty. A clear graft, however, does not
give a good visual result if high corneal astigmatism prevents the
successful wearing of spectacles or contact lenses. This article describes
the methods and results of two microsurgical techniques--the corneal wedge
resection to steepen the flat meridian and relaxing incisions to flatten
the steep meridian. Average reduction in corneal astigmatism was greater
for the wedge resection (ten cases) (6.50 diopters as compared with 4.25 D
[16 cases] for the relaxing incisions). The relaxing incisions operation
was successful in 75% of cases with stabilization of corneal curvature
readings in an average of three weeks and is an outpatient procedure. After
a wedge resection, corneal stabilization usually takes months. We believe
that wedge resection should be reserved for cases in which relaxing
incisions are unsuccessful.
