Influence of Preoperative Corneal Thickness to Postoperative Astigmatism and Endothelial Cell in Keratoconus Penetrating Keratoplasty

ABSTRACT

PURPOSE: Corneal transplantation is ultimately required in progressed keratoconus, although initial treatment involves a non-surgical method. We attempted to explore the time point at which corneal transplantation becomes necessary by comparing of postoperative astigmatism and corneal endothelial cells between hydrop and non-hydrop groups. METHODS: Among keratoconus patients who received corneal transplantation between January 2000 and January 2003 from one surgeon, postoperative Sim K, astigmatism, endothelial cells and visual acuity were checked and compared with preoperative data in 20 hydrops eyes and 16 non-hydrops eyes. Finally we evaluated the correlation of postoperative astigmatism with preoperative astigmatism and decreased corneal thickness. RESULTS: There was no significant difference in postoperative Sim K, astigmatism, visual acuity, or endothelial cell reduction rate between the two groups, and the correlation of postoperative astigmatism with large preoperative astigmatism and thin cornea was also not significant. CONCLUSIONS: There is no prognostic difference between eyes undergoing penetrating keratoplasty prior to and after the development of hydrops. Based on our results, keratoconus should be treated conservatively until corneal transplantation becomes inevitable.