Penetrating rekeratoplasty in eyes with secondary corneal dystrophy
First Author: V.Naumenko RUSSIA
Comparative evaluation of the biological and optical results of penetrating rekeratoplasty in patients with secondary corneal dystrophy with the results of penetrating keratoplasty performed for the first time.
S. Fyodorov Eye Microsurgery Federal State Institution. Saint-Petersburg. Russia.
A comparative analysis of the results of penetrating rekeratoplasty was performed in 176 patients of the main group and the сomparable control group, where penetrating keratoplasty was performed for the first time. The patients in the main group had secondary endothelial epithelial corneal dystrophy. In all rekeratoplasty surgerys unconserved corneal grafts with a diameter of 7.0-9.0 mm with ECD ≥2000 cells were used. Pre- and post-operatively the standard and special diagnostic methods were used (keratotopography, keratopachymetry, anterior segment optical coherence tomography, confocal microscope). Biological and optical results in both groups were evaluated in terms of 2 to 11 years.
Biological and optical results were monitored in both groups over a period of 3 to 11 years. Сlear corneal grafts in the main and control group was noted in 77.3% and 85.0%, respectively; partially clear - 17.3% and 10.4%; not clear - 5.3% and 4.6%. After 3 years a decrease in ECD in both groups led to a decrease of corneal grafts transparency in the main group by 33.9%, in the control group - 26.8%(P<0.05). Optical results: visual acuity up to 0.05 was established in the main and control groups, respectively, in 27.9% and 11.7% of patients, 0.06-0.09 - 21.3% and 16.8%, 0.1- 0.4 - 31.9% and 45.4%, more than 0.5 in 18.7% and 26.1%. After 3 years visual acuity in patients of the main group decreased by 37.5%, in the control group - 30.4% (P<0.03).
A comparative analysis of the biological and optical results of penetrating rekeratoplasty and penetrating keratoplasty performed for the first time revealed a direct correlation between the functional results of RCP and the volume of manipulations performed, the course of the postoperative period and, especially, the rate of postoperative ECD loss (P <0.05).