PURPOSE: To analyze the corneal wavefront higher order aberrations (HOAs) after penetrating keratoplasty and selective suture removal. METHODS: All patients undergoing penetrating keratoplasty by the same surgeon (R.K.F.) using identical suturing technique were retrospectively identified. Corneal HOAs were calculated at the week 6, week 10, 6-month, and final postoperative visits and compared with simulated corneal astigmatism, surface regularity index, surface asymmetry index, and best-corrected visual acuity. RESULTS: Ninety-two eyes were identified. Total corneal HOAs declined from the week 6 visit to the final visit (week 6: 0.65, final: 0.50, P = 0.041). Final visit linear regression demonstrated correlations of surface asymmetry index and surface regularity index with total corneal HOAs (R = 0.51 and R = 0.45, respectively). No relationship for simulated corneal astigmatism or vision was found with total corneal HOAs (R = 0.003 and 0.30, respectively). CONCLUSIONS: Total corneal HOAs are increased in the early postkeratoplasty course, possibly representing the optical consequences of surface irregularity. Because simulated keratometry provides no information in regard to corneal HOAs, measuring HOAs may be indicated in select cases. Total corneal HOAs perhaps provide a clinical representation of irregular astigmatism. The visual significance of these total corneal HOAs was not evident.
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