- 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.
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