Astigmatism management after corneal transplantation - A State of Sight #44

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Isaac Porter, MD discusses options to control astigmatism that may occur after a corneal transplant in this episode of A State of Sight. As explained in episode #7 of A State of Sight (Astigmatism...): • Astigmatism, toric len... astigmatism is an uneven curvature of the cornea.
Corneal transplants including penetrating keratoplasty (PKP) and deep anterior lamellar keratoplasty (DALK) replace the central part of the cornea which is the clear covering over the front of the eye. These grafts are attached with sutures around the circular transplant to hold it in place. As time passes, wound healing occurs and the sutures can be removed, usually from 6 months to two years or later after the operation. This wound healing can be unpredictable and cause changes in the curvature of the cornea, creating astigmatism.
Fortunately, this astigmatism can be managed with glasses, toric contact lenses, and rigid gas permeable contact lenses. However, if the amount of astigmatism is greater than these lenses will correct, surgical options may be considered.
It is possible to create incisions in the cornea to lower the amount of astigmatism or relax the wound between the transplant and the host cornea. Also, additional sutures can be placed at the same time in a different location to steepen the cornea in that area and help to balance the astigmatism. The excimer laser that is used for LASIK and PRK can be very accurate in treating astigmatism and may be used following corneal grafts in patients who are good candidates.
Have any questions about astigmatism or how astigmatism can be treated after corneal transplantation? Please post below.
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27 сен 2012

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Комментарии : 11

@snopsiebarnett 11 лет назад

Thank you for this informative video. I had a corneal transplant 3 years ago (Keratoconsis), Went back to my eye surgeon, and he said I had an astigmatism. He did an in office procedure however my eye sight has not improved much. He now wants to do a procedure that has to done in the OR. Your video was very helpful in making me aware, that what I am undergoing is not an uncommon problem. Thank You

@simonlindsell1267 11 лет назад

Even though you're an American MD (and I'm in good ol' Blighty!), I've found this very informative, as I've been told I need a corneal graft - haven't worked up the nerve to watch a surgery video yet, though

@LosingMyFatMind 10 лет назад

Is it normal for astigmatism to get worse after a corneal transplant? My vision was very good after my surgery but has gotten progressivly worse to the point it's the same as pre-surgery. One of my sutures came loose about 2 months after surgery. Most likely because I wasn't wearing my shield at night, and they removed just the one loose suture, from my understanding this caused an uneven pull on the cornea, is this correct?

@shivjhawar 3 года назад

Just watched your very interesting video. Thank you. Unfortunate: After 18 months of corneal graft, I was told last week by an ophthalmologist (referred to by the eye surgeon who performed corneal transplant surgery - penetrating keratoplasty) that because I have a low 20/200 vision in my aphakic eye (cataract was so hard that the posterior lens capsule came out with it -- no intraocular lens was put in), no use even wearing a contact lens. What do you think? Is another surgery possible to remove the irregular surface caused by the corneal graft? Any eye exercise should I do?

@moussamhanna 7 лет назад

hello i have had a corneal transplant 16 years ago (2000) in my right eye because of keratoconus, after 3 years of the transplant i had a lazik surgery to get rid of the astigmatism , the vison has improved but not so long, last year i have redo the lazik surgery but my vision did not improved so much, i still see blurry and cannot read book or on my mobile, it get worth at night, any assistance i can get is appreciated :)

@raj-fj6fg 11 лет назад

sir the doctor had told me to have laminar surgery of cornea as cornea is blured in the centre .....doctor says prk cannot be applied as the depth of scar 450um something and limit it 150um for prk .should i go for it or any other solution

@2024Politics_3 4 года назад

What causes the eye to get cloudy upon waking up? Is it diet? Edema drops seem to work sometimes but some days it is so cloudy it’s like a winshield thats fogged up.

@livefreewithlove 6 лет назад

how is the retina protected while fixing the cornea with a laser?

@iralk 10 лет назад

I had a corneal transplant a lil over a year ago. The stutures were moved 1 year and 2 weeks later. I have'nt had any complications whatsover, the doctor is very pleased with the process. He says that in about 5 weeks I can get fitted for contacts. I have kerataconus on both eyes. Can the kerataconus come back on the newly transplanted cornea? Btw, awesome video...something my doc has explained but somehow I really understood you better!