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Manual half-top-hat versus conventional penetrating keratoplasty

Poster Details

First Author: S.Eissa SAUDI ARABIA

Co Author(s):                  

Abstract Details


The aim of this study is to determine if half-top-hat PKP is able to make wound healing faster; with subsequent early suture removal in comparison with regular PKP. In addition, the following questions are tried to be answered: 1. Is it easy to perform? 2. Is it time consuming? 3. Does it achieve a rapid visual rehabilitation? 4. Is it a safe procedure?


All surgeries were performed in the ophthalmic surgical unit of Kasr El Aini teaching hospital; Cairo university, from May 2008 to July 2009.


This is a prospective ,comparative, non-randomized study that was performed on 30 eyes of 30 patients divided into two groups; group I (HTH-PKP) and group II (conventional PKP), each comprised of 15 patients


Both procedures provided nearly similar visual and refractive outcomes. It was observed intraoperatively by the surgeons, that in group I (HTH) ; the wound was watertight with the minimal need for suture tightening, since the IOP tends to push the healing surfaces together. Healing in group I was better after 4 months compared to the 8 months healing in group II. Average time for sutures removal in group I was 5.5 months and 11.5 months in group II.


HTH configuration has a larger area of apposition, as the whole recipient cornea is in good apposition with the donor. 2)More watertight than a regular top-hat PKP. 3) Fewer Descemet’s folds and presumably induce less high-order aberration. 4) Better tectonic support and a lesser risk for wound dehiscence. 5) Surgery is relatively easier and faster to perform compared to a regular full top-hat configuration; no recipient bed pocket peparation.

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