Surgical correction of postkeratoplastyastigmatism with the Hanna arcitome

Abstract

To report the results of arcuate keratotomy performed with the Hannaarcitome in patients with postkeratoplasty astigmatism. Department of Ophthalmology, Saint-Antoine Hospital, Paris VI University, Paris, France. This retrospective study comprised 22 eyes (22 patients) with postkeratoplasty astigmatism. Paired symmetrical arcuate keratotomy was performed with the Hanna arcitome. Outcome measures included refraction, videokeratography, and keratometry. At 6.6 months ± 8.9 (SD) after surgery, the mean increase in best spectacle-corrected visual acuity (BSCVA) was 2.1 ± 2.4 lines. Thirteen eyes gained 2 lines or more of BSCVA, and 15 gained 3 lines or more of uncorrected visual acuity. Two patients had a decrease in BSCVA: 1 had lens opacification unrelated to arcuate keratotomy and 1, increased corneal irregularity. Mean refractive astigmatism was 6.94 ± 2.11 diopters (D) preoperatively and 3.85 ± 1.95 D postoperatively (P < .01). Mean change in keratomeric astigmatism was −51 ± 36%. Astigmatism decreased in 21 eyes as measured by manifest refraction, keratometry, and videokeratography; it increased in 1 cornea with a microperforation. The results of arcuate keratotomy performed with the Hanna arcitome were comparable to those with freehand relaxing incisions. The instrument made safer and more uniform arcuate incisions than a freehand technique.