Clinical and Anatomical Study of the Effect of Transscleral Fixation of Posterior Chamber Lenses on Early Post keratoplasty Astigmatism
作者:
David Hardten,
Edward Holland,
Donald Doughman,
J Daniel Nelson,
Anthony Evangelista,
Jeffrey Ketcham,
期刊:
Cornea
(OVID Available online 1993)
卷期:
Volume 12,
issue 4
页码: 282-288
ISSN:0277-3740
年代: 1993
出版商: OVID
关键词: Astigmatism;Posterior chamber lens;Penetrating keratoplasty;Transsclerally sutured posterior chamber lens;Pseudophakia
数据来源: OVID
摘要:
We reviewed the pattern of astigmatism after penetrating keratoplasty and transsclerally sutured posterior chamber lens (TSPCL) placement in 73 patients. Thirty-five patients (48%) had an axis of astigmatism oriented perpendicularly to the haptics of the TSPCL. Twenty-seven patients (37%) had an orientation of astigmatism that was in the same meridian as the haptics of the TSPCL. Eleven patients (15%) had an axis of astigmatism oriented obliquely to the meridian of the haptics of the TSPCL. The distance the haptic fixation sutures were placed behind the limbus appeared to be correlated with the orientation of astigmatism. Patients having the lens fixated within 0.75 mm of the limbus were more likely to have astigmatism oriented perpendicular to the meridian of the haptics of the posterior chamber lens in the early postoperative period. Patients having the lens fixated 2-3 mm posterior to the limbus were more likely to have astigmatism oriented in the same meridian as the haptics of the posterior chamber lens in the early postoperative period. In an eye bank model of TSPCLs during penetrating keratoplasty, the placement of a posterior chamber lens with haptics fixated within 0.75 mm of the limbus significantly widens the recipient bed an average of 0.3 mm in the meridian of the haptics of lens placement (p=0.02). When the posterior chamber lens haptics were fixated 3 mm posterior to the limbus, the recipient bed was significantly narrowed in the meridian of lens placement an average of 0.2 mm (p=0.02). It appears that the TSPCLs may have an effect on early postkeratoplasty astigmatism by distorting the corneal wound at the time of keratoplasty.
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