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First Author: D.Ancona-Lezama MEXICO
Co Author(s): A. Pérez-Balbuena P. Rentería-Ruíz A. Sentieri-Omarrementeria
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The aim was to present our experience with penetrating autokeratoplasty and to propose it as a secure, viable alternative to conventional allograft transplantation for the management of corneal blindness in patients with a healthy cornea in the fellow blind eye. We also intend to expand the knowledge regarding autokeratoplasty, since there in not much reported in literature worldwide.
Despite newer procedures, graft rejection continues to pose a significant risk to the long-term survival of the corneal graft. Autokeratoplasty is a powerful alternative in high-risk grafts, because it negates the risk of graft rejection and minimizes the requirement of postoperative steroids.
We did a retrospective analysis of a series of three cases of corneal blindness in which the transparent cornea from a blind eye was transplanted onto the fellow eye with a favorable visual potential but an opaque cornea. These cases were treated with autokeratoplasty in our hospital Asociación Para Evitar La Ceguera en México. Dr. Luis Sánchez Bulnes from 2011 to date.
Spectacle-corrected vision improved in all cases postoperatively. Intraoperative complications included posterior capsule opacification. All patients mantained a clear graft until the last follow-up (5-23 months). Overall cost of this procedure was less in comparison to conventional allograft transplantation.
Penetrating Autokeratoplasty is a plausible alternative for patients without access to donor corneal tissue and that are not eligible or cannot undergo conventional allograft transplantation. This procedure should be reserved only for carefully selected patients. It must be performed judiciously in the case of one eye possesing a clear cornea with a loss of vision secondary to posterior segment affection while the contralateral eye has a favorable visual potential limited only by an opaque cornea. The use of autologous tissue avoids the risk of rejection after penetrating keratoplasty, and given the need of a second corneal transplant (this time allograft), the graft rejection rates would compare a first-time corneal transplantation.