Abstract

P 214

Astigmatism in penetrating keratoplasty with guided trephination system (GTS)

Birnbaum F., Böhringer D., Potsch C., Schmidt M., Reinhard T.
Universitäts-Augenklinik Freiburg

Objective: Astigmatism is a major problem following penetrating keratoplasty. The guided trephination system (GTS) allows for reduced tension in sutures due to improved congruency of the graft/ recipient interface. Aim of this study was to compare, whether mid term graft astigmatism is reduced from GTS trephination as compared to historical controls comprising of keratoplasties with conventional trephine.
Methods: Penetrating keraplasty was performed in 56 patients, using the GTS. Keratometric astigmatism was assessed from Orbscan keratography one year postoperativly the earliest with sutures still in place in some cases. The historical control comprises of 151 keratoplasties from conventional trephination. In these cases, astigmatism was assessed from Zeiss keratometry after complete suture removal. Keratometric astigmatism was compared between both groups using the Kruskal Wallis Test.
Results: Mean follow up was 1.5 years in the GTS group and 4.9 years at time of keratometry in the controls. Mean astigmatism was 4.3 diopters in the GTS group as compared to 5.2 diopters in the controls. The difference turned out statistically signifikant (p=0.04).
Conclusions: GTS trephination seems to allow for a moderate reduction in mid-term postoperative astigmatism following penetrating keratoplasty. Long-term data, however, have yet to be collected.

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