Corneal Transplantation: Penetrating Keratoplasty

2020 ◽  
pp. 151-162
Author(s):  
Richard S. Koplin ◽  
David C. Ritterband ◽  
Emily Schorr ◽  
John A. Seedor ◽  
Elaine Wu
Keyword(s):  
Penetrating Keratoplasty ◽  
Corneal Transplantation

Primary surgical options for acute corneal hydrops: A review

2021 ◽  
pp. 112067212110378
Author(s):  
Gonzalo García de Oteyza ◽  
Guido Bregliano ◽  
Irene Sassot ◽  
Luis Quintana ◽  
Carolina Rius ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Medical Therapy ◽  
Penetrating Keratoplasty ◽  
Corneal Transplantation ◽  
Corneal Edema ◽  
Self Healing ◽  
Surgical Options ◽  
Corneal Hydrops

Acute corneal hydrops usually resolves alone or with medical therapy along the first 4–6 weeks. However, depending on the severity of the corneal edema or the size of the Descemet break, self-healing might be difficult. Years ago, those patients had no more options than corneal transplantation, but surgical alternatives are on the rise in this century. These surgeries are becoming more popular with a variety of techniques relegating penetrating keratoplasty to a residual role. These techniques aim to accelerate corneal healing, reduce the edema, improve visual acuity and prevent from severe complications that may appear if corneal hydrops is not treated rapidly. Feasibility and safety are the favorable aspects of these techniques since the complications rates described remain low. In this review, we emphasize the recently published studies that describe both the techniques and their results.

scholarly journals Total Corneal Transplantation after Trauma

2017 ◽  
Vol 17 (2) ◽  
pp. 37-38
Author(s):  
Elina Silina ◽  
Guna Laganovska
Keyword(s):  
Healthy Donor ◽  
Penetrating Keratoplasty ◽  
Ocular Trauma ◽  
Corneal Transplantation ◽  
Visual Outcome ◽  
Corneal Tissue ◽  
Full Thickness ◽  
Documented Case ◽  
Donor Graft ◽  
Penetrating Ocular Trauma

Abstract The first successful corneal transplantation is known since 1905, performed by Eduard Zirm (2). It has been implemented in order to restore vision in a variety of corneal diseases and after ocular traumas. The traditional technique for corneal transplantation, penetrating keratoplasty (PKP), refers to the full-thickness replacement of corneal tissue with a healthy donor graft (1). Authors report a well-documented case about successfully transplanted cornea after penetrating ocular trauma to improve visual outcome.

scholarly journals Corneal graft survival analysis after penetrating keratoplasty in a retrospective cohort study

2021 ◽  
pp. 12-20
Author(s):  
B.E. Malyugin ◽  
◽  
S.N. Sakhnov ◽  
V.V. Myasnikova ◽  
A.V. Klokov ◽  
...  
Keyword(s):  
Cohort Study ◽  
Survival Analysis ◽  
High Risk ◽  
Graft Survival ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Penetrating Keratoplasty ◽  
Corneal Transplantation ◽  
Minimal Risk ◽  
General Group

Purpose. To assess the results of penetrating keratoplasty and identify the risk factors for the graft disease (GD) development. Material and methods. Data of 582 patients after corneal transplantation performed in the period since 2011 to 2019 for keratoconus (41%), as well for corneal leucorrhoea and dystrophies (59%), aggravated by concomitant pathology, the so-called high-risk keratoplasty (HRK) were analyzed in a retrospective cohort study. We estimated the functional results and incidence of GD. The calculation of the t-criterion; cross-tabulation method; Kaplan–Meier survival analysis and multivariate analysis were applied. Results. As a result of penetrating keratoplasty, the BCVA (best corrected visual acuity) in patients with keratoconus increased by 20%; in patients with HRK – by 8%. In the general group the graft survival rate was 72%, while the 8-year successful graft engraftment in patients with keratoconus comprised 91%, with HRK – 60%. A significant relationship of the GD development with preoperative diagnosis and rekeratoplasty was determined. The risk of GD incidence was minimal in patients under 30 years of age and maximum in patients aged from 50 to 70 years. Survival rates for corneal transplants were better in men than in women. Conclusion. Penetrating keratoplasty in patients with keratoconus provides a good functional result with a minimal risk of GD development. With penetrating keratoplasty in high-risk patients, the effectiveness of surgical interventions is significantly lower (by ~30%). Key words: keratoconus, penetrating keratoplasty, corneal transplantation, survival analysis

scholarly journals Recurrent Keratoconus

2013 ◽  
Vol 2 (2) ◽  
pp. 65-68
Keyword(s):  
Penetrating Keratoplasty ◽  
Treatment Options ◽  
Corneal Transplantation ◽  
Wound Dehiscence ◽  
Lamellar Keratoplasty ◽  
Deep Anterior Lamellar Keratoplasty ◽  
Time To Recurrence ◽  
Anterior Lamellar Keratoplasty ◽  
Corneal Thinning ◽  
Corneal Disorder

Abstract Keratoconus is an ectatic corneal disorder characterized by progressive corneal thinning and protrusion. Keratoconus recurrence after corneal transplantation although rare is present and has been confirmed histologically. Host, donor, genetic, mechanical and environmental factors have been proposed as predisposing factors to initiate keratoconus recurrence. The time-to-recurrence post-deep anterior lamellar keratoplasty seems to occur earlier than after penetrating keratoplasty. Wound dehiscence and high astigmatism post-transplant are plausible differential diagnosis for this entity. The treatment options are similar to primary keratoconus. Since, the era of collagen corneal cross-linking, early diagnosis is desirable as it could halt the progression of recurrent keratoconus. How to cite this article Barbara R, Barbara A. Recurrent Keratoconus. Int J Kerat Ect Cor Dis 2013;2(2):65-68.

scholarly journals Recent Advances and Anaesthetic Considerations in Corneal Transplantation

2018 ◽  
Vol 46 (2) ◽  
pp. 162-170 ◽  
Author(s):  
A. W. Y. Chua ◽  
M. J. Chua ◽  
P. C. A. Kam
Keyword(s):  
General Anaesthesia ◽  
Penetrating Keratoplasty ◽  
Corneal Transplantation ◽  
Lamellar Keratoplasty ◽  
Individual Risk ◽  
Cell Transplant ◽  
Repeat Surgery ◽  
Risk Benefit Assessment ◽  
Wide Range ◽  
Surgical Conditions

Significant surgical advances have been made recently in corneal transplantation. Penetrating keratoplasty was the dominant method from 1905, until selective lamellar keratoplasty emerged as the preferred technique over the last 20 years. Advanced techniques such as corneal limbal stem cell transplant and keratoprosthesis are also available. The major surgical complications of corneal transplantation are extrusion of ocular content and expulsive choroidal haemorrhage. It is essential for an ophthalmic anaesthetist to have a good understanding of these new surgical procedures so as to provide optimal surgical conditions. This article aims to inform anaesthetists about the recent surgical advances in corneal transplantation and explore the anaesthetic considerations of these new techniques. General anaesthesia remains suitable for a wide range of these procedures especially in repeat surgery, difficult, or prolonged procedures. Regional ophthalmic blocks are ideal for endothelial keratoplasty but can be used in penetrating keratoplasty based on individual risk–benefit assessment, and as a supplement to general anaesthesia. Topical anaesthesia provides an alternative when general anaesthesia and ophthalmic regional blocks are less desirable but overall its use is limited.

scholarly journals To Evaluate the Effectiveness of Plasmapheresis as a Method for the Graft Disease Prevention in Patients with Keratoplasty

2021 ◽  
Vol 18 (4) ◽  
pp. 946-954
Author(s):  
S. N. Sakhnov ◽  
V. V. Myasnikova ◽  
K. I. Melkonyan ◽  
S. V. Kravchenko
Keyword(s):  
Penetrating Keratoplasty ◽  
Comparison Group ◽  
Corneal Transplantation ◽  
Perioperative Period ◽  
Main Group ◽  
Surgical Pathology ◽  
Control Group ◽  
Preoperative Period ◽  
Rejection Reaction ◽  
Graft Disease

Purpose: to evaluate the effectiveness of plasmapheresis as a method for preventing and treating the graft rejection reaction in corneal transplantation.Patients and methods. The study involved patients with surgical pathology of the cornea, who underwent a prophylactic course of plasmapheresis procedures and underwent penetrating keratoplasty (Main group); and patients with surgical pathology of the cornea who underwent penetrating keratoplasty, but did not undergo plasmapheresis (Comparison group), whose data were analyzed retrospectively. The control group consisted of conditionally healthy individuals of both genders. Subgroups of patients with high and low risk keratoplasty were also identified within the Main group and the Comparison group.Results. Patients with keratoplasty who received a course of therapeutic plasmapheresis in the perioperative period demonstrated a statistically significant increase in the number of cases of a decrease in the level of C-reactive protein and a statistically significant decrease in the median values of the mean stimulated cytochemical index and the mobilization coefficient. Depending on the risk group for keratoplasty, the patients showed different dynamics of the levels of the studied interleukins after the course of plasmapheresis and keratoplasty. In patients of the Comparison group who did not receive a course of plasmapheresis in the preoperative period, over a period of 1.3 years, 22 cases (24 %) developed graft disease, while patients of both subgroups of the Main group who received a course of therapeutic plasmapheresis in the preoperative period, didn’t demonstrate any cases of graft disease. In patients of the Comparison group (in total for two subgroups), the maximum number of cases of graft disease (n = 24) was observed in the first 500 days after surgery. At the same time, the patients of the Main group who underwent plasmapheresis had the best graft survival rates: during the observation period, there were no cases of graft disease (in both subgroups).Conclusion: the obtained data indicate the ability of plasmapheresis, performed in the perioperative period, to prevent the development of graft disease in patients with keratoplasty.

scholarly journals Corneal Imaging and Densitometry Measurements in Patients with Fuchs' Dystrophy Undergoing Penetrating Keratoplasty and Descemet's Striping Automated Endothelial Keratoplasty

2021 ◽  
Author(s):  
Khaled Alzahrani ◽  
Arun Brahma ◽  
Fiona Carley ◽  
M. Chantal Hillarby
Keyword(s):  
Visual Acuity ◽  
Penetrating Keratoplasty ◽  
Corneal Thickness ◽  
Corneal Transplantation ◽  
Objective Evaluation ◽  
Endothelial Keratoplasty ◽  
Evaluation Tool ◽  
Corneal Densitometry ◽  
Post Surgery ◽  
Fuchs Dystrophy

Abstract Aims:In the present study, we used the densitometry software from the Oculus Pentacam to compare postoperative corneal clarity between penetrating keratoplasty (PK) and Descemet's stripping endothelial keratoplasty (DSAEK) in patients with Fuchs' dystrophy.Methods:A retrospective comparative study was carried out at Manchester Royal Eye Hospital. In 28 patients with Fuchs' dystrophy, corneal densitometry measurements were performed 12–18 months after corneal transplantation. The correlations of the densitometry measurements with the best corrected visual acuity (BCVA) and central corneal thickness (CCT) were analysed and compared between eyes that underwent PK and those that underwent DSAEKResults:Corneal densitometry measurements in the 33 eyes showed no significant differences between the PK and DSAEK post-surgery groups. There was no significant correlation between CCT and corneal densitometry measurements in either group (P > 0.05 in both cases). After DSAEK, corneal densitometry measurements were significantly correlated with BCVA in the central (P = 0.01), posterior (P = 0.007), and full-depth (P = 0.008) 0–2 mm zones of the cornea but not in PK group. The postoperative CCT was significantly different between the two groups (P˂0.01).Conclusion:The two types of corneal transplantation resulted in different outcomes in terms of corneal densitometry measurements. Improved visual acuity after DSAEK was found to positively correlate with improvements in corneal clarity. Oculus Pentacam provides an objective evaluation tool to monitor corneal status after surgery.

Sign in / Sign up

Export Citation Format

Share Document