Predictors for postpenetrating keratoplasty astigmatism: A retrospective cohort study.

Purpose: To identify the possible predicting factors for developing astigmatism following penetrating keratoplasty, namely age, gender, laterality, preoperative indication for surgery, size of donor and recipient graft, and selective versus total sutures removal. Moreover, the duration of postoperative topical steroids use and if that surgery was the first graft or a redo surgery.

Methods: A retrospective cohort study which included data of patients who underwent penetrating keratoplasty at the University of Jordan Hospital. Multiple local and systemic perioperative risk factors were evaluated concerning developing postoperative astigmatism.

Results: Three hundred and ninety-two eyes were included. Of those, 38.8% developed postoperative significant astigmatism. Significant astigmatism postkeratoplasty was found to be affected by preoperative diagnosis with corneal dystrophy being the most common indication associated with significant postoperative astigmatism. Significant astigmatism was significantly correlated with long-term topical steroid use, longer follow-up duration, and the first keratoplasty (P < 0.001). No correlation was found between significant astigmatism, age, and the time of suture removal.

Conclusion: Determination of the factors that influence the development of significant astigmatism is crucial. A long-term follow-up is necessary as the incidence of significant astigmatism increases with time.