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Keratoplasty in stromal corneal dystrophies

Poster Details

First Author: R.Rajagopal INDIA

Co Author(s):    P. Naveen   P. Padmanabhan   B. Joytirmoy        

Abstract Details



Purpose:

Analyse functional and anatomical results of patients undergoing lamellar/penetrating keratoplasties (LK/PK) for stromal dystrophies. Data was also reviewed for postoperative complications.

Setting:

Medical Research Foundation, Sankara Nethralaya, 18 College Road, Chennai - 600 006, Tamil Nadu, India.

Methods:

Retrospective review of case records of 25 eyes of 24 patients who underwent LK/PK between Jan 2008 - Dec 2012 in a tertiary care centre for stromal corneal dystrophy. Patients with a minimum follow-up of 6 months after surgery were included in the study.

Results:

Mean age was 40 years, mean follow up was 6 months. Stromal dystrophies included granular, macular and lattice dystrophy in 6, 17 and 2 eyes respectively and was confirmed on histopathology. 12 eyes underwent PK (manual 11 eyes, femto PK 1 eye) and 13 eyes underwent LK (manual 12 eyes, automated 1 eye). Functional improvement in vision was noted in 18 eyes (8 LK, 10 PK). At final follow-up, 20 eyes had clear grafts (12 LK, 8 PK). Interface haze was noted in 4 eyes in the LK group. Recurrence was noted in 1 eye in LK group at 13 months and was managed conservatively 5 eyes had rejection (LK-2 eyes and PK - 3 eyes) at an average of 9 months(12 months in LK and 6 months in PK). Rejection was treated with intravenous steroids followed by oral and topical steroids in 2 patients and only with oral and topical steroids in 3 patients. Regraft was performed in 1 eye following rejection. Postoperative glaucoma was noted in 7 eyes (LK 3, PK 4)and was treated medically in 6 eyes. One patient in the PK group required surgical intervention.

Conclusions:

Keratoplasty in stromal corneal dystrophies gives good anatomical and functional outcome. Recurrences are quite rare. FINANCIAL INTEREST: NONE

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