Moran Eye Center researchers present first report of CK for post-PKP astigmatism

Conductive keratoplasty (CK) appears to be an effective and safe surgical option for treating astigmatism in eyes that are post-penetrating keratoplasty (PKP), said Darcey H. Wolsey, MD, MPH.

Dr. Wolsey, resident, John A. Moran Eye Center, University of Utah, Salt Lake City, reported on outcomes of 12 post-PKP eyes of 12 patients treated with CK. Eligibility criteria for the procedure required that patients be at least 18 years old and have astigmatism of at least 0.75 D along with stable refraction for a minimum of 6 months and an adequate peripheral corneal thickness.

The procedure was performed with the "light touch" technique placing the spots in the flat axis of astigmatism. The majority of the cases (75%) were performed with the spots placed just inside the graft margin and in the remaining cases the spots were placed outside or both inside and outside the graft. The mean number of spots placed was 4 with a range from 2 to 6.

Mean preoperative cylinder was about 5 D, and it was reduced by about 2.2 D on day 1. However, there was gradual regression of the effect thereafter, so that by 3 months, the average reduction from baseline was only about 1.5 D. Despite the regression, patients reported subjective improvement in vision. Best spectacle-corrected visual acuity (BSCVA) improved by 1 to 3 lines in five eyes and no eye lost BSCVA.

"CK does seem to offer a safe modality for treating astigmatism in these challenging eyes that is easy for surgeons and the patients and associated with fast recovery," Dr. Wolsey said. "Now, further studies are needed to develop a nomogram and determine its long-term safety and efficacy."