Early postkeratoplasty astigmatism following placement of anterior chamber lenses and transsclerally sutured posterior chamber lenses.

Intraocular pseudophakic correction during penetrating keratoplasty (PK) for aphakic or pseudophakic bullous keratopathy may be achieved either with anterior or posterior chamber lenses. Posterior chamber lenses can be fixed to the iris or sclera in eyes lacking adequate posterior capsular support. Post-PK astigmatism can delay early visual rehabilitation of the patient. We reviewed the last 15 patients at our institution who had undergone PK and anterior chamber lens placement for bullous keratopathy. These were compared to the last 15 patients who had undergone PK and transsclerally sutured posterior chamber lens placement. Patients who had placement of a flexible anterior chamber lens at time of PK had a mean astigmatism of 6.73 D at the last visit before any sutures were removed. There was no predominant axis of astigmatism or relationship of the axis of astigmatism to the meridian of lens placement. Patients with placement of a transsclerally sutured posterior chamber lens at time of PK had a mean astigmatism of 5.18 D at the last visit before any sutures were removed. Mean astigmatism was not significantly different (P greater than 0.05) from that seen with anterior chamber lens placement. In the majority of patients the axis of post-PK astigmatism was oriented perpendicular to the meridian of the transsclerally sutured posterior chamber lens.