Autologous Penetrating Keratoplasty：A New Approach For Hyperdense Cataract In Eyes With Very Severe Microcornea And Iris-Choroid Coloboma

To investigate the feasibility of autologous penetrating keratoplasty in the treatment of hyperdense cataract with very severe microcornea and iris-choroid coloboma.

Beijing Aier-Intech Eye Hospital,Beijing,China

The clinical data of 5 patients (6 eyes) with hyperdense cataract complicated with very severe microcornea and iris-choroid coloboma who received surgical treatment in Beijing Aier-Intech Eye Hospital, from June 2017 to May 2023 were retrospectively analyzed. Autologous penetrating keratoplasty was performed. The cornea was drilled with trephine with corresponding corneal diameter after preoperative marking, the cornea slices were removed and stored in fresh sterile preservation solution, the lens nucleus was removed, the residual cortex was imbibed with I/A infusion, and the cornea slices were sutured in situ. The implant bed was well engaged, and the anterior chamber was formed. The postoperative follow-up time was more than 6 months.

This study included 2 male patients with 3 eyes and 3 female patients with 3 eyes. The patient's age ranged from 54 to 65 years, with a mean age of 57.2 years. The corneal diameter ranged from 5 to 6mm, and the cataract nuclear hardness was grade 4 or above. The mean visual acuity before surgery was 2.33±0.196LogMAR, and the mean visual acuity 6 months after surgery was 1.77±0.22LogMAR, with statistical significance. After surgery, all patients had clear cornea. The visual acuity of 4 patients (5 eyes) was improved compared with that before surgery, and the visual acuity of 1 patient (1 eye) was not significantly improved after surgery, but the patient's conscious visual field was significantly improved.

Autologous penetrating keratoplasty combined with extracapsular cataract extraction may be considered for the patients with very severe microcornea and iris-choroid coloboma.