Correction of Refractive Errors after Corneal Transplantation

Abstract

Even after a successful keratoplasty with a clear graft, a high postoperative refractive error could occur too hard to correct with spectacles or contact lenses. Therefore, refractive surgery could be considered a good tool to correct these high postoperative defects. The authors showed the reasons involved in the refractive errors after successful penetrating (PKP) or lamellar transplantation (DALK), pre-, intra-, and post-operatively. Moreover, they presented different techniques to correct the refractive errors after transplantation for different corneal pathologies, in the plastic phase (managing of transplant sutures) as well as in the static phase (different refractive techniques: incisional (AK, FemtoAK), ablative (PRK, FemtoLASIK), or IOL implantation (Phakic IOL, PHACO + IOL)). Thus, it is necessary to study accurately every single clinical case to choose the best surgery for each patient. Due to the high risk of graft damage or graft rejection, the patient must be adequately informed about the risks and benefits of the surgery proposed and must specifically accept the possibility of a new corneal transplant in the event of surgery failure or graft damage. Certainly, the refractive surgeon must be able in managing all the different refractive surgery techniques to reach the best result in every single case.