Samir A Quawasmi
Cornea Specialized Clinic, Jordan
Title: Paired Arcuate and Modified Circular Keratotomy in Keratoconus
Biography
Biography: Samir A Quawasmi
Abstract
Aim: To reduce astigmatism, increase corneal volume and improve visual acuity. Methods: A retrospective, single-surgeon, single centre, clinic-based study of a surgical procedure on twenty-four eyes of fourteen patients diagnosed with stage-III or stage IV keratoconus. Paired arcuate keratotomy coupled with modified circular keratotomy was performed at a single center by a single surgeon as an outpatient procedure with local anesthetic in a minor surgery room. Modified circular keratotomy was performed 7 mm from the papillary centre with depth of incision ranging between 70% and 90% of corneal thickness. Arcuate keratotomy was performed 2.5mm from the papillary centre with the depth of incision at 90% of corneal thickness. Angular length of the arcs ranged between 60° and 120° depending on the astigmatic power of the cornea. Results: Astigmatism decreased in 87.5% of the 24 treated eyes, increased in 8.33% and did not change in 4.17%. Corneal volume increased in 91.66% of the 24 eyes and decreased in 8.34%. Visual acuity improved in 100% of the eyes; there was a mean improvement of 59% from preoperative visual acuity, 8.34% of the treated eyes reaching a visual acuity of 1.0 (20/20) with correction. No complications occurred during or after surgery. No suturing was performed and there was no rupturing at incision sites. There was statistical significance difference between pre-sph against post-sph (P=0.001). Also between pre.cyl against post.cyl (P=0.005), there was no significance difference between pre-axis against post-axis (P=0.05). Conclusion: Paired arcuate keratotomy coupled with modified circular keratotomy should be considered as an intervention before performing keratoplasty.