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Postmortem evaluation of axis-orientation after Astigmatism-Oriented Penetrating Keratoplasty (AOPKP)J. A. Reichelt, G. Grütters, B. Nölle
Background: Reduction of astigmatism following penetrating keratoplasty can be achieved if the transplant is oriented according to astigmatism parameters in donor and host (AOPKP). Postmortem evaluation of these parameters, however, may be influenced by cachexy of the donor, ocular hypotony, epithelial disorders following long periods from death to explantation or open eyelids after death. The aim of our investigation was to compare different methods of postmortem evaluation of astigmatism in donor corneas. As example served the eyeballs of a patient with axis-orientation known before.
Method: The 72-year-old female patient had underwent AOPKP on her right eye. Parameters of astigmatism could be followed up for three years. The corneas of the eyeballs were examined with a hand-keratometer 4.5 hours after death but before enucleation: First without pressure on the eyeballs, and then under palpatory normal ocular pressure. After explantation the corneas of the eyeballs were examined by computer-assisted topography (TMS-1) and again by hand-keratometry directly before trephination under sterile conditions.
Results/Conclusion: Comparison of different techniques of astigmatism measurements in one eye without previous surgery and another eye after AOPKP revealed that hand-keratometry is advantageous over computer-assisted topography. It showed higher exactness and better re-test results. As far as our AOPKP study is concerned, these results are of great interest: Reduction of postoperative astigmatism following penetrating keratoplasty is only possible if reliable astigmatism data of donor and host corneas are available.
Department of Ophthalmology, Christian Albrechts University Kiel, Hegewischstrasse 2, D-24105 Kiel, Germany