Corneal transplantation in aniridia-related keratopathy with a two-year follow-up period, an uncommon disease with precarious course

Acta Ophthalmol. 2023 Mar;101(2):222-228. doi: 10.1111/aos.15229. Epub 2022 Aug 9.

Abstract

Purpose: The purpose of this study is to study the frequency, surgical transplantation technique and outcome in patients with aniridia-related keratopathy (ARK) with two-year follow-up period.

Methods: A retrospective registry-study including all ARK cases performed in Sweden and Denmark between 2001 and 2016 and registered in the Swedish Cornea Transplant Registry.

Results: A total of 36 eyes of 26 patients were subjected to corneal transplantation due to ARK during 2001 to 2016. Penetrating keratoplasty (PK) was the procedure of choice in 58.3% (n = 21) of the eyes, followed by a combination of PK and limbal stem cell transplantation in 13.9% (n = 5) and keratolimbal allograft in 13.9% (n = 5). Boston keratoprosthesis was used in 8.3% (n = 3), and anterior lamellar keratoplasty in 5.6% (n = 2). Thirteen of the procedures (36.1%) were retransplantations. Two years after surgery 26 cases were available to follow-up of which 16 of the grafts were functioning (61.5%). The median visual acuity showed a trend of improvement from hand motion to counting fingers.

Conclusions: A majority of the ARK cases (61.5%) had a graft providing useful vision for the patient 2 years after corneal transplantation, but the visual gain was modest at best. Longer follow-up time is required to evaluate functional graft outcomes. Despite the introduction of limbal stem cell transplantation as a suitable treatment, PK was the most common surgical method in the present study.

Keywords: aniridia; aniridia-related keratopathy; corneal transplantation; registry-study; surgical method.

MeSH terms

  • Aniridia* / complications
  • Aniridia* / surgery
  • Cornea / surgery
  • Corneal Diseases* / complications
  • Corneal Diseases* / diagnosis
  • Corneal Diseases* / surgery
  • Corneal Transplantation*
  • Follow-Up Studies
  • Humans
  • Keratoplasty, Penetrating
  • Prostheses and Implants
  • Retrospective Studies
  • Vision Disorders / surgery