Suture adjustment for postkeratoplasty astigmatism

Excessive corneal astigmatism following penetrating keratoplasty is a frequent problem. A technique that adjusts a single running 10-0 nylon suture after keratoplasty was used in this series of patients. The procedure requires a keratometer, slitlamp, topical anesthesia, and tying forceps. In 52 eyes, with an average of 10.0 diopters of keratometric astigmatism, we adjusted the suture to flatten the steep corneal axis. We were able to reduce astigmatism an average of 7.2 diopters and this remained stable three months post wound revision.