ESCRS - PP11.17 - Clinical Outcomes Of Two-Piece Microkeratome-Assisted Mushroom Keratoplasty For Corneal Hydrops In Keratoconus

Clinical Outcomes Of Two-Piece Microkeratome-Assisted Mushroom Keratoplasty For Corneal Hydrops In Keratoconus

Published 2023 - 41st Congress of the ESCRS

Reference: PP11.17 | Type: Free paper | DOI: 10.82333/khsj-ej46

Authors: Rossella Spena* 1 , Angeli Christy Yu 1 , Marco Pellegrini 1 , Andrea Sollazzo 2 , Cristina Bovone 3 , Massimo Busin 4

1Department of Translational Medicine,University of Ferrara,Ferrara,Italy;Department of Ophthalmology,Ospedali Privati Forlì, “Villa Igea”,Forlì,Italy, 2Department of Ophthalmology,Ospedali Privati Forlì, “Villa Igea”,Forlì,Italy, 3Department of Environmental Sciences and Prevention,University of Ferrara,Ferrara,Italy;Department of Ophthalmology,Ospedali Privati Forlì, “Villa Igea”,Forlì,Italy, 4Department of Translational Medicine,University of Ferrara,Ferrara,Italy;Department of Ophthalmology,Ospedali Privati Forlì, “Villa Igea”,Ferrara,Italy

Purpose

To report the outcomes of 2-piece microkeratome-assisted mushroom keratoplasty
(MK) for eyes with corneal scarring secondary to hydrops in keratoconus.

Setting

Ospedali Privati Forlì, "Villa Igea", Forlì, Italy

Methods

In this single-center study, 31 consecutive eyes with corneal scarring secondary to
hydrops in keratoconus that underwent 2-piece microkeratome-assisted mushroom
keratoplasty were evaluated. The 2-piece mushroom graft consisted of an anterior
lamella 9 mm in diameter and a posterior lamella 6 mm in diameter. Outcome measures
were best spectacle-corrected visual acuity (BSCVA), refractive astigmatism (RA),
endothelial cell density, and post- operative complication rates. Mean follow-up was 6±4
years.

Results

Baseline logMAR BSCVA significantly improved from 1.73 ± 0.67 to 0.11 ± 0.67
(p<0.001). Refractive astigmatism was greater than 4.5 diopters in only 3 cases (9.6%)
of cases after wound revision for high-degree astigmatism in 7 cases. Endothelial cell
loss was 37% at 1 year. Stromal rejection occurred in 2 eyes (6.5%) and endothelial
rejection occurred in 1 eye (3.2%), which eventually developed failure requiring
posterior lamellar exchange.

Conclusions

Two-piece microkeratome-assisted MK for corneal scarring secondary to hydrops in
keratoconus can allow excellent visual rehabilitation with relatively stable ECL and low
rates of immunologic rejection and graft failure.