Astigmatism

Symptoms

• Limited visual acuity despite clear corneal graft.

Causes

• More frequently occurs in eyes with pre-operative keratoconus, severe scaring, or corneoscleral defect.
• Irregular suture placement, uneven suture tightness or technical error during the corneal button trephination.
• Sometimes donor astigmatism.

Management

• Suture manipulation or removal for tension redistribution.
• May be corrected with eyeglasses or contact lenses.
• In cases where refractive corrections do not provide satisfactory vision due to high residual astigmatism, a variety of surgical options may be employed such relaxing incisions, compression sutures, excimer laser photoastigmatic refractive keratectomy or LASIK.