Usually the reaction is overcome and the graft remains clear. Large amounts of astigmatism are common following keratoplasty. The patient's spectacle prescription may fluctuate for some months following surgery. Refractive changes and keratometry or corneal topography can be used to follow the healing process. After Surgery Most transplants have significant astigmatism and often some distortion requiring correction with contact lenses made of rigid materials.
Many factors make fitting contacts after transplant a challenge.
It is common for the edge of the transplant to be slightly raised with respect to the surrounding cornea. The graft is usually steeper than the normal cornea, and may be tilted with respect to the surrounding tissue. To combat high amounts of astigmatism some of the sutures may be removed early. Following healing a relaxing incision or a wedge resection may be done to decrease the astigmatism. In any case there is usually some distortion of the transplant and most patients will obtain better vision with a rigid contact lens.