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Corneal radius of curvature after anterior lamellar versus penetrating keratoplasty

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Abstract

Background

Keratoplasty may induce major spherical refractive error related to abnormal corneal radius of curvature (CRC).

Methods

Two hundred and thirty-eight consecutive eyes of 238 patients with clear graft and at least one postoperative Orbscan examination performed after suture removal (average follow-up time, 86 months) were retrospectively analyzed. Anterior lamellar keratoplasties (ALK group, n = 119) and penetrating keratoplasties (PK group, n = 119) were matched for preoperative diagnosis and lens status.

Results

The average postoperative, suture-out, Orbscan 3-mm CRC was 7.17 mm with a wide 95 % confidence interval [6.26 mm; 8.37 mm]. It was 7.05 mm in the ALK group and 7.31 mm in the PK group (p < 0.01). In the ALK group, this figure was 7.00 mm for oversized grafts and 7.67 mm for non-oversized grafts (p < 0.001). CRC values were significantly lower for eyes with keratoconus (7.00 mm) or stromal scar after infectious keratitis (7.06 mm) compared with stromal scar after trauma (7.74 mm) or stromal dystrophies (8.17 mm). Values were significantly lower for big-bubble ALKs (6.92 mm) and manual dissection-ALKs (7.14 mm) compared with PKs (7.31 mm) and microkeratome-assisted ALKs (7.45 mm). The average Orbscan 3-mm SimK cylinder, irregularity, and refractive power symmetry index were, respectively, 4.7 D/4.8 D/1.9 D for ALKs and 5.2 D/4.8 D/1.8 D for PKs (p = 0.99).

Conclusions

The CRC is lower after ALK compared with PK, and features important variability. In eyes with ALK, non-oversized grafts result in postoperative CRC close to normal values and corneal diseases associated with stromal thinning and DALK result in lower postoperative CRC.

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Acknowledgments

Supported by Université Pierre et Marie Curie-Paris 6, Paris, France. The sponsor or funding organization had no role in the design or conduct of this research.

Conflict of interest

No conflicting relationship exists for any author.

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Authors and Affiliations

  1. Centre Hospitalier National d’Ophtalmologie des XV-XX, Pierre & Marie Curie University Paris 06, Clinical Investigation Centre 503, 28 rue de Charenton, 75012, Paris, France

    Vincent M. Borderie, Cristina Georgeon, Marie Borderie, Nacim Bouheraoua, Olivier Touzeau & Laurent Laroche

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  1. Vincent M. Borderie
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  2. Cristina Georgeon
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  3. Marie Borderie
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  4. Nacim Bouheraoua
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Correspondence to Vincent M. Borderie.

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Borderie, V.M., Georgeon, C., Borderie, M. et al. Corneal radius of curvature after anterior lamellar versus penetrating keratoplasty. Graefes Arch Clin Exp Ophthalmol 252, 449–456 (2014). https://doi.org/10.1007/s00417-013-2545-7

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  • DOI: https://doi.org/10.1007/s00417-013-2545-7

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