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Corneal Transplantation and Refractive Surgery Intersect

Roger F. Steinert, MD

Arch Ophthalmol. 2008;126(2):263-264.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

The corneal endothelium is incapable of proliferation. When the cellular pump function drops below the minimum capacity to maintain deturgescence of the stroma, corneal edema ensues. For half a century, the only successful treatment of endothelial failure has been full-thickness penetrating keratoplasty. Penetrating keratoplasty has many well-known operative and postoperative challenges. One of the most vexing has been the slow recovery of vision postoperatively, often reaching a suboptimal plateau marked by spectacle acuity below the retinal potential, high amounts of astigmatism, irregular astigmatism (now more accurately known as high-order aberrations), and ongoing difficulties with suture loosening and vascularization, infection, and dehiscence of the incision. While long-term clarity of corneal grafts is typically high, the quality of vision often does not match the appearance at the slitlamp examination. An all-too-frequent observation is that a skilled contact lens fitter is a corneal surgeon's best friend.

In 1999, Gerrit . . . [Full Text of this Article]

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