Two-Piece Microkeratome-Assisted Mushroom Keratoplasty Outcomes In The Treatment Of Post Radial Keratotomy Scarring And Ectasia

Published 2022 - 40th Congress of the ESCRS

Reference: FPM02.10 | Type: Free paper | DOI: 10.82333/7qt3-4q94

Authors: Patricia Escribano Lopez* ¹ , James Myerscough ¹ , Angeli Christy Yu ² , Marco Pellegrini ² , Rossella Spena ² , Massimo Busin ²

¹Department of Ophthalmology,Ospedali Privati Forlì “Villa Igea”,Forlì,Italy, ²Department of Translational Medicine,University of Ferrara,Ferrara,Italy;Department of Ophthalmology,Ospedali Privati Forlì “Villa Igea”,Forlì,Italy

Purpose

To report the outcomes of a two-piece microkeratome-assisted mushroom keratoplasty in the treatment of post radial keratotomy corneal scarring and ectasia.

Setting

Tertiary Eye Care Referral Center (Ospedali Privati Forlì “Villa Igea”, Forlì, Italy).

Methods

This was a single center interventional case series of consecutive patients undergoing mushroom keratoplasty for corneal scarring and/or ectasia after radial keratotomy (RK). The graft was prepared by microkeratome and consisted of an anterior lamella of 9mm and a posterior lamella of 6mm. Primary outcomes were refractive astigmatism (RA) and best spectacle-corrected visual acuity (BSCVA). Secondary outcomes were surgical and postoperative complications, and endothelial cell density (ECD).

Results

Fourteen eyes of 14 patients suffering from corneal scarring and/or ectasia following RK were included, with a mean age of 57.6±7.4 years, and a mean follow-up duration of 3.3±3.0 years. At the final follow up, BSCVA (logMAR, mean±SD) improved from 0.92±0.34 preoperatively to 0.3±0.36 postoperatively (p=0.005). RA reduced from 4.9±3.0 diopters preoperatively to 2.3±1.5 diopters postoperatively (p=0.04). Endothelial cell loss was 46±22.3%. There were no episodes of graft rejection or failure during the follow up period.

Conclusions

Two-piece microkeratome-assisted mushroom keratoplasty is technically feasible in the treatment of post radial keratotomy scarring and ectasia, with refractive and visual outcomes that appear comparable to those of deep anterior lamellar keratoplasty.