Purpose of review
To review the different surgical procedures for management of postkeratoplasty refractive errors after total
suture removal.
Recent findings
There are different surgical options to address residual refractive errors that frequently occur after corneal
transplantation. The correction can be done on the corneal surface or intraocular with intraocular lens (IOL)
implantation which requires complete tectonic and refractive stability after suture removal. The most
commonly used procedures are photorefractive keratectomy, laser in-situ keratomileusis and Phakic IOLs.
Keratoplasty has been profited by recent advances in refractive surgery. Custom excimer laser ablation is
an alternative way to treat irregular errors. New IOL modalities are good practical options for a wide
range of errors. Femtosecond laser, as a new option in the toolbox, can modify corneal grafting refractive
results and assist corrective refractive procedures.
Summary
Although being the most successful organ transplantation, keratoplasty is usually followed by significant
ametropia. Different corrective modalities exist and the choice should fit ocular conditions, patient
requirements, surgeon skills and the available technologies. Recent advances in ophthalmic surgery have
improved the outcomes.