Compressive C-shaped lamellar keratoplasty: A surgical alternative for the management of severe astigmatism from peripheral corneal degeneration

Abstract

Objective: To describe a compressive lamellar surgical technique for treating severe astigmatism in peripheral corneal ectasia. Design: Retrospective, noncomparative, interventional case series. Participants: Four eyes of 3 patients with either pellucid or Terrien's marginal corneal degeneration were included in this series. Methods: C-shaped lamellar keratoplasty using multiple trephines of different sizes, with deliberate undersizing of the donor graft for a controlled compressive effect, was performed on these patients. Main Outcome Measures: Visual acuity outcome and refraction were measured at different intervals at up to 40 months of follow-up. Results: All eyes achieved Snellen visual acuity of 20/40 or better and stable astigmatism ranging from 0 to -2.75 diopter cylinder within 6 months, with no recurrence of corneal thinning or peripheral corneal vascularization. Conclusions: Compressive C-shaped lamellar keratoplasty is able to reduce severe corneal astigmatism in peripheral corneal ectasia and can result in good visual and refractive outcomes with early visual rehabilitation. © 2005 by the American Academy of Ophthalmology.