الفهرس 
Anatomy of the corneaOnly 14 pages are availabe for public view
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Abstract
Visual acuity after successful penetrating keratoplasty depends
mainly on the clarity of the graft and the refractive error, particularly
the astigmatic component. Severe irregular astigmatism is often seen
after keratoplasty and can delay visual rehabilitation, even with a clear
graft.
The precise apposition at the graft- host junction is an important
goal of penetrating keratoplasty (PK) and also a prognostic factor
affecting the surgical outcome. In our study we evaluate this
apposition by AS-OCT and correlate it with the postoperative
astigmatism.
The current study, was done on 44 eyes with PKP done for five
different underlying diseases (keratoconus, corneal dystrophy, trauma,
corneal scar after bacterial corneal ulcer and post herpetic corneal
scar). All patients underwent full ophthalmologic examinations
including best-corrected visual acuity, refraction, slit-lamp
biomicroscopy, intraocular pressure, keratometric astigmatism using
an autorefractometer, evaluation of postoperative topographic
astigmatism using corneal topography and evaluation of the graft–host
interface using a spectral domain AS-OCT of CIRRUS™ HD-OCT
5000 withFastTrac™ from ZEISS. We analyzed correlations between
the wound profile of post PKP eyes (graft host junction) by AS-OCT
and the postoperative topographic astigmatism by corneal topography.
In the present study, A total of 176 graft–host junctions from 44
eyes were analyzed. Of these, 77.3% (68 cross-sections) had malapposed
junction at flat meridian and 72.7% (64 cross sections) had
mal- apposed junction at steep meridian. 22.7 % (20 crosssections) had well-apposed junction at flat meridian and 27.3% (24 cross
sections) had well-apposed junction at steep meridian.
The distribution of the alignment pattern at steep and flat
meridians was highly significant different between the preoperative
diagnosis groups (P less than 0.001). BCVA (Decimal), keratometric
astigmatism and Central graft thickness were significantly different
between alignment groups with p values of 0.020, 0.010 and 0.002
respectively.
In the current study, malapposed junction state was associated
with higher degree of mean postoperative keratometric astigmatism
than the well-apposed junction state. In addition, mean SE was higher
in the well-apposed junction state than in the mal-apposed junction
state. Mean BCVA was better in the well-apposed junction state.