Changes in Astigmatism after Suture Removal in Penetrating Keratoplasty

PURPOSE: To study a refractive change after suture removal and to evaluate some factors for this change in penetrating keratoplasty. METHODS: We studied 53 eyes of 47 patients who had undergone penetrating keratoplasty. Subjective refraction and best corrected visual acuity were measured in all eyes before and after the removal of sutures. We also classified the subject eyes based on suture removal time, degree of astigmatism before suture removal, recipient trephine size and compared the change of astigmatism within the groups. RESULTS: Suture removal decreased the astigmatism by an average of 0.81 diopter (D) (p=0.02) and increased the best corrected visual acuity by an average of 0.17 (p=0.005). These results show that corneal astigmatism tends to decrease more with early suture removal (p=0.010), higher degree of astigmatism before suture removal (p<0.05) and smaller size of recipient trephine (p=0.014). CONCLUSIONS: The removal of entire suture after penetrating keratoplasty decreases corneal astigmatism. Furthermore, the outcome is influenced by suture removal time, degree of astigmatism before suture removal, and recipient trephine size.

Two Cases of Recurrent Keratoconus

PURPOSE: To report two cases that showed clinical findings of recurrent keratoconus following penetrating keratoplasty. METHODS: A 39 year-old male and a 34 year-old female developed clinical signs of recurrent keratoconus in his left and her right eye 3 and 8 years after keratoplasty, respectively, and he underwent successful corneal regrafting. RESULTS: We confirmed recurrence of keratoconus histopathologically through the examination of the cornea of the recipient who underwent corneal regrafting and chromosomal study showed mosaicism, 47,XXY/46,XY. CONCLUSION: We report the histopathologic feature of one case of recurrent keratoconus for the first time in Korea.

3 Cases of Latanoprost Associated Herpes Simplex Keratitis

PURPOSE: To report three cases in which herpes simplex keratitis developed after initiation of latanoprost. METHODS: We experienced three patients with herpes simplex keratitis after latanoprost instillation, two patients with open angle glaucoma and one is congenital glaucoma. We preformed herpes simplex virus culture for two cases. RESULTS: One patient with history of herpes simplex keratitis, resolution when latanoprost was stopped; antiviral therapy could not eradicate herpes simplex keratitis until latanoprost was discontinued. The second patient with latanoprost associated herpes simplex keratitis cleared with discontinuation of latanoprost and start of antiviral therapy. The third patient had resolution, only when latanoprost was stopped. The result of viral cultures for two cases was negative. CONCLUSIONS: Clinicians should be aware of development or recurrence of herpes simplex keratitis when laranoprost is used for intraocular pressure control.