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Clinical rehabilitation of patient with post-infectious central corneal opacity after penetrating keratoplasty by topography-guided photorefractive keratectomy

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Session Details

Session Title: Presented Poster Session: Keratorefractive Results I

Venue: Poster Village: Pod 2

First Author: : R.Makarov RUSSIA

Co Author(s): :    I. Mushkova   N. Maichuk           

Abstract Details

Purpose:

To assess clinical and functional results of the Topography-guided Photorefractive Keratectomy (TT-PRK) performing in the patient with post-infectious central corneal opacity developed at the post-keratoplasty eye

Setting:

The S. Fyodorov Eye Microsurgery Federal State Institution, Moscow, Russia

Methods:

Twenty nine years female, 1 year after bacterial keratitis with central corneal opacity developed in her post penetrating keratoplasty (post-PK) right eye, was undergone TT-PRK. Manifest spectacle refraction, best spectacle-corrected visual acuity (BSCVA), uncorrected visual acuity (UCVA), corneal density, endothelial cell count (ECC), central corneal thickness (CCT), corneal opacity depth (COD), tears osmolarity (TO) and topographic indexes of surface regularity (surface regularity index (SRI) and surface asymmetry index (SAI)) were evaluated before and up to 6 months after TT-PRK performed with excimer laser MicroScan-Visum and KeraScan software (OptoSystems, Russia).

Results:

TT-PRK was uneventful and the epithelial corneal healing duration was 6 days. 6 months after TT-PRK the UCDVA improved significantly from 20/100 to 20/40, and the BSCVA from 20/100 to 20/32. The SAI and SRI improved from 3.19 to 1.23 and from 1.64 to 1.02, respectively. The mean corneal density changed from 34.5 to 20.4. TO changed from 288 mOsm/l to 297 mOsm/l, but no signs of ocular surface dryness were detected. The ECC was stable (2035 cells/mm2 before & 2032 cells/mm2 after TT-PRK). CCT changed from 491µm to 388µm and COD from 183µm to 87µm

Conclusions:

Despite the fact the corneal graft has a low sensitivity and insufficient neurotrophic functioning due to the incomplete re-innervation which resulted in a prolonged period of epithelial healing and a slight increasing of a TO, no signs of ocular surface dryness were detected. TT-PRK with Russian made excimer laser and software in post-infectious corneal opacity treatment allowed significantly increase UCVA and BSCVA as well as improve corneal transparency. The technique seems to be safe and effective for treating stromal corneal opacity in postPK eye

Financial Disclosure:

NONE

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