Peripheral corneal ulceration - surgical options
First Author: C.Mateus Guedes Mota PORTUGAL
Co Author(s): E. Lopes D. Maleita D. Hipólito-Fernandes N. Alves J. Feijão V. Maduro
Peripheral corneal ulcerations (PCU) can cause devastating visual outcomes. Challenging surgical approaches are often required for its management. The aim of our study is to describe anterior semilunar lamellar keratoplasty technique and its outcomes in this condition.
Cornea and Transplants Unit – Ophthalmology Department – Lisbon Central Universitary Hospital Centre
Retrospective observational study of two patients diagnosed with PCU. Patient one is a fifty-three year old female with rheumatoid arthritis; patient two is a fifty-five year-old male with a Mooren’s ulcer. Both were submitted to anterior semilunar lamellar keratoplasty. Donor tissue was obtained by cutting an anterior cornea lamella [obtained from Descemet’s Stripping Automated Endothelial Keratoplasty (DSAEK) preparation] to fit perfectly at the recipient bed. The procedures were performed without any intra-operative complications.
Before the surgical procedure, patients’ involved eye had a best corrected visual acuity (BCVA) of 20/100. At 12 months follow-up, the first patient BCVA was 20/40 and the second patient BCVA was 20/30. Corneal astigmatism improved over the follow-up period, remaining stable after suture removal: a mean value of 6D ± 1,5D (3 months); 3D ± 1,86D (6 months); 2,95D ± 1,75D (12 months). Regarding post-operative complications, both patients developed cataract over the long-term and glaucoma, controlled with topical treatment.
Semilunar anterior grafts are associated with good visual acuity recovery and a low/medium corneal astigmatism after suture removal. This tissue-saving surgical approach enables two different corneal transplants from a single harvest, making it a very efficient procedure.