Wavefront-Guided Photorefractive Keratectomy in the Treatment of High Astigmatism Following Keratoplasty.

To report the outcome of wavefront-guided photorefractive keratectomy (WG-PRK) in the treatment of high astigmatism following keratoplasty. A retrospective, interventional analysis including patients with high astigmatism following either penetrating keratoplasty or deep anterior lamellar keratoplasty, who underwent WG-PRK. Thirteen eyes (7 right eyes) of 12 patients (10 male) aged 35.1 ± 5.9 years were included. Preoperative astigmatism ranged between 3.00 and 5.00 D. Average follow-up time was 14.0 ± 6.2 months. Uncorrected distance visual acuity (UDVA) improved from 0.97 ± 0.58 logarithm of the minimum angle of resolution (logMAR) (Snellen equivalent ∼20/187) preoperatively to 0.13 ± 0.15 logMAR (Snellen equivalent ∼20/27) at 6 months and 0.14 ± 0.16 logMAR (Snellen equivalent ∼20/28) at the final follow-up (P = 0.001 and P = 0.002, respectively). UDVA ≥20/40 increased from 1 eye (7.7%) preoperatively to 13 eyes (100%) at 6 months and 12 eyes (92.3%) at the final follow-up (P < 0.001 for both). UDVA ≥20/25 increased from 1 eye (7.7%) preoperatively to 6 eyes (46.2%) at 6 months and at the final follow-up (P = 0.027 for both). Mean astigmatism improved from -3.98 ± 0.75 D to -1.27 ± 0.82 D and -1.40 ± 1.04 at 6 months and at the last follow-up, respectively (P = 0.001 for both). Preoperative astigmatism was ≥3.00 D in all eyes and was reduced to ≤2.50 D in all eyes at 6 months postoperatively, with 7 eyes (63.6%) having ≤1.00 D of astigmatism at both 6 months and the final follow-up. WG-PRK was safe and effective in the treatment of high and regular postkeratoplasty astigmatism.