Circular keratotomy combined with wedge resection in the management of high astigmatism after penetrating keratoplasty

Objective: To evaluate the effectiveness of circular keratotomy combined with wedge resection for the management of high astigmatism after penetrating keratoplasty (PK). Methods: The study included seven eyes of seven patients with previous PK who underwent circular keratotomy combined with wedge resection. The uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA), spherical equivalent (SE) refraction, and keratometric powers obtained by corneal topography were evaluated. The power vector method was used to analyze the astigmatic change postoperatively. Results: The mean follow-up period was 18.42 +/- 8.56 months (range 12-33 months). Uncorrected visual acuity, BCVA, and SE were improved in all eyes postoperatively. The mean preoperative astigmatism reduced from 15.11 +/- 5.48 D (range, 10.0-24.4 D) to 4.98 +/- 3.01 D (range, 2.2-9.6 D), postoperatively. According to the vector analysis, the overall mean surgically induced astigmatism at last visit was 12.87 +/- 6.20 D. The most common complication was the loosening of sutures occurred in five eyes within 2 months. Conclusions: Circular keratotomy combined with corneal wedge resection is a favorable option for the management of high astigmatism after PK.