Oversized corneal grafts for corneal opacities with iridocorneal adhesions

Ophthalmology. 2001 Nov;108(11):2026-8. doi: 10.1016/s0161-6420(01)00772-2.

Abstract

Objective: To evaluate the efficacy of 1-mm oversized corneal grafts in patients with acquired corneal opacities and extensive peripheral iridocorneal adhesions.

Design: Prospective noncomparative case series.

Participants: Twenty patients (20 eyes) aged 15 years or older with unilateral or bilateral corneal opacification and a shallow anterior chamber.

Intervention: Penetrating keratoplasty was performed with donor corneal buttons oversized by 1 mm.

Main outcome measures: The various parameters evaluated were visual acuity, graft clarity, keratometry, anterior chamber depth, intraocular pressure, and spherical equivalent refraction 12 months after surgery.

Results: The keratoplasties were performed in 15 eyes with a corneo-iridic scar after infectious keratitis (75%) and 5 eyes with failed graft (25%). At the final follow-up, a clear graft was achieved in 17 eyes (85%), and 14 eyes (70%) achieved a best-corrected visual acuity of 6/12 or better. Three of the grafts failed because of rejection. The average keratometry was 44.1 +/- 1.0 diopters (D), and the mean spherical equivalent was -3.23 +/- 2.86 D. The oversized grafts provided a mean anterior chamber depth of 2.36 +/- 0.42 mm, and the mean intraocular pressure at the 12 month follow-up was 16.38 +/- 2.09 mmHg.

Conclusions: Corneal grafts oversized by 1 mm provide adequate anterior chamber depth and reduce the risk of peripheral anterior synechiae and secondary glaucoma in patients with corneal opacities and extensive peripheral iridocorneal adhesions.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anterior Chamber / anatomy & histology
  • Cornea / anatomy & histology
  • Corneal Opacity / surgery*
  • Female
  • Glaucoma / prevention & control
  • Graft Survival
  • Humans
  • Intraocular Pressure
  • Iris Diseases / prevention & control
  • Iris Diseases / surgery*
  • Keratoplasty, Penetrating / methods*
  • Male
  • Middle Aged
  • Prospective Studies
  • Refraction, Ocular
  • Tissue Adhesions / prevention & control
  • Tissue Adhesions / surgery
  • Tissue Donors
  • Visual Acuity