Abstract:

Penetrating keratoplasty (PKP) can restore vision or control the development of corneal disease. A successful corneal graft requires both clarity and an acceptable refraction. After PKP, astigmatism remains a challenge for corneal refractive surgeons, it is a limiting factor in the visual rehabilitation of otherwise successful corneal grafts. The management of postkeratoplasty astigmatism include two stages: in the first stage, it managed by suture manipulation: suture removal along the steep meridian of astigmatism and suture adjustment, which can change the corneal curvature, and decrease the corneal astigmatism. If significant astigmatism remains after suture removal, it can be corrected by optical means or surgical procedures. The optical means include spectacles and contact lenses. The doctors usually use rigid gas-permeable contact lenses and scleral contact lenses. The surgical procedures include traditional incisional keratotomy, wedge resection and modern intrastromal corneal ring segments, laser refractive surgery, intraocular lens implantation and so on. Femtosecond laser (FSL) technology has been recently introduced in the clinical practice, it can increase the safety and efficacy, otherwise it also can decrease the complication.