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Original Article
Corneoscleral transplantation for end stage corneal disease
  1. Lawrence W Hirst,
  2. Graham A Lee
  1. Division of Ophthalmology, Department of Surgery, University of Queensland, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
  1. Professor Lawrence W Hirst, 2nd Floor Lions Building, Princess Alexandra Hospital, Ipswich Road, Woolloongabba, Queensland, Australia, 4102.

Abstract

AIM To describe the prognosis and complications of corneoscleral transplantation in the management of end stage eye disease.

METHODS A case series is presented of 23 patients who have undergone corneoscleral transplantation (⩾11 mm). Patients were examined for visual acuity, intraocular pressure, recurrence of disease process, epithelialisation of the graft, signs of rejection, and other potential complications.

RESULTS 14 patients retained their eye, with six maintaining a clear graft. Vision ranged from 6/30 to no perception of light. 13 patients developed glaucoma (range 25–69 mm Hg), with six patients requiring surgical intervention. 12 patients required tarsorrhaphy to promote epithelialisation. Only two grafts resulted in typical rejection.

CONCLUSIONS The technique of corneoscleral transplantation can salvage otherwise end stage eye disease, but the results are poor with respect to maintenance of vision. These patients need careful follow up because of potential complications of glaucoma, epithelial defects, rejection, and recurrence of disease.

  • corneoscleral graft
  • end stage corneal disease
  • sclerokeratoplasty

https://doi.org/10.1136/bjo.82.11.1276

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