Oversized corneal grafts for corneal opacities with iridocorneal adhesions
Section snippets
Materials and methods
Twenty eyes of 20 patients, aged 15 years or older, were enrolled from the cornea service of our hospital. Eyes with corneo-iridic scars and failed grafts with flat or shallow anterior chambers with extensive PAS were included in this study. Eyes with posterior segment pathology, uncontrolled glaucoma (intraocular pressure [IOP] > 21 mmHg on one topical medication), and subnormal electrophysiologic tests (visual evoked potential and electroretinogram) were excluded.
Initial evaluation included a
Results
Of the 20 patients enrolled in our study, 14 were males and 6 were females, with a mean age of 46.8 ± 17.4 years (range, 15–75 years). The major indications for corneal grafting were corneo-iridic scar caused by infectious keratitis in 15 eyes (75%) and failed grafts in 5 eyes (25%). The donor trephination graft size was 8.5 mm in 16 eyes (80%) and 9.0 mm in 4 eyes (20%). Pupilloplasty and anterior segment reconstruction were required in 12 eyes, and goniosynechiolysis was performed in all of
Discussion
A corneal button oversized by 0.5 mm is traditionally used for corneal grafting in adults.3, 4, 5 Corneal opacification along with iridocorneal adhesions is one of the major indications for corneal grafting in this part of the world, and most of these cases have a shallow anterior chamber preoperatively.1, 2 It has been our experience that despite optimal suturing and synechiolysis, many patients with preexisting iridocorneal adhesions have a shallow anterior chamber, PAS, and raised IOP during
References (14)
- et al.
Oversize corneal donor grafts in penetrating keratoplasty
Ophthalmology
(1979) - et al.
Oversized grafts in children
Ophthalmology
(1999) - et al.
Dental mirror for goniosynechiolysis during penetrating keratoplasty
Am J Ophthalmol
(1985) - et al.
Results of anterior segment reconstruction for aphakic and pseudophakic corneal edema
Ophthalmology
(1988) - et al.
Anterior synechiolysis after keratoplasty
Ophthalmic Surg
(1995) - et al.
Protection of the iris by lamellar dissection of corneal layers. A technique in penetrating keratoplasty
Cornea
(1994) - et al.
Transplant size and elevated intraocular pressurepostkeratoplasty
Arch Ophthalmol
(1978)