To report the use of circular keratotomy in eyes with
stage I and II keratoconus to reduce astigmatism.
A retrospective analysis was performed of all eyes
operated from 1993 to 2006 by one surgeon using circular keratotomy for stage I
and II keratoconus. Results were evaluated for reduction of corneal
astigmatism, refractive stability, and change in best spectacle-corrected
visual acuity (BSCVA).
Forty-six eyes in 36 patients were evaluated. Corneal
(keratometric) astigmatism and refractive astigmatism were significantly
reduced, particularly in eyes with preoperative astigmatism ≥2.00 diopters
(D). Preoperative astigmatism correlated with reduction of astigmatism
(R=0.81). Astigmatism stabilized after 1 year in 64% of 28 eyes that were seen
both within the first year after surgery and then at some time point ≥2
years after surgery. In this group, astigmatism changed ≤2.00 D in 94% of
eyes between 1-year follow-up and the last examination. Mean BSCVA improved
from 20/44 to 20/33 (P<.01), with 20 (43%) of 46 eyes gaining 2 lines
or more, 22 (48%) of 46 eyes changing by less than 2 lines, and 4 (9%) of 46
eyes having a worse BSCVA at the last examination compared with preoperatively.
Circular keratotomy provides significant reduction in
astigmatism, improved BSCVA, and stabilization of astigmatic changes in most
eyes, although some eyes show limited benefit. Eyes with higher preoperative
astigmatism appear to be more likely to benefit from the procedure than those
with lower preoperative astigmatism. Circular keratotomy also resulted in
reasonable clinical results for the treatment of stage I and II keratoconus.
[J Refract Surg. 2009;25:357-365.]
From Clinic Krumeich, Bochum, Germany (Krumeich); and
SurgiVision Consultants Inc, Scottsdale, Ariz (Kezirian).
Dr Krumeich holds the patent for the Guided Trephine
System (GTS®) manufactured by Polytech, Rossdorf, Germany, used to perform
circular keratotomy. Dr Kezirian has no financial interest in the materials
Correspondence: Jorg H. Krumeich, MD, Clinic Krumeich,
28-30 Propst-Hellmich-Promenade, 44866 Bochum, Germany. Tel: 49 2327 82002;
Fax: 49 2327 88171; E-mail: firstname.lastname@example.org
Received: August 28, 2007; Accepted: July 11, 2008
Posted online: September 30, 2008