Correction of postkeratoplasty astigmatism by razor blade and V-shaped knife wedge resection.

Improvement in microsurgical techniques and tissue storage has resulted in a higher rate of clear grafts after penetrating keratoplasty. The postoperative astigmatism however still remains a major problem. If a high corneal astigmatism cannot be managed successfully with glasses or contact lenses, a surgical approach may be indicated. We developed a V-shaped knife which makes a crescentic wedge resection easier to perform. Before the introduction of the V-shaped knife we obtained an average reduction in corneal astigmatism of 6.6 diopters. With the V-shaped knife the reduction was 8.0 diopters. We think that the V-shaped knife makes a wedge resection easier and safer.