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AbstractSA.10.05 Tactics of the therapeutic keratoplasty at severe inflammatory corneal diseases Drozhina G. I., Ivanovskaya E. V., Gaydamaka T. B., Ostashevskiy V. L., Usov V., Kochkariov A. V.
The Filatov Institute of Eye Diseases and Tissue Therapy, Odessa, Ukraine Objective: To study the efficiency of therapeutic keratoplasty (TKP) in the treatment of severe inflammatory corneal diseases.
Methods: The results of 173 TKP performed at 164 patients in age 26 - 63 year (M=51,9±SD14,9) with different inflammatory corneal processes since 2004 till 2006 in the Corneal pathology and microsurgery department were analysed. Etiology of corneal inflammatory processes were: herpetic 56 eyes (32,4%), bacterial 22 (12,7%), mixed (herpetic complicated by secondary bacterial or fungal infection 51(29,5%), fungal 2 (1,2%), traumatic 9 (5,2%), trophic keratitis 20 (11,6%), autoimmune 10 (5,8%). Indications for TKP were: severe keratitis at 32 eyes (18,5%), ulcers 119 eyes (68,9%), including perforating 60 eyes and complicated descemetocele 15 eyes, corneal abscesses 12 eyes (6,9%), keratomalacia 10 eys (5,8%). There were performed different kinds of TKP - 93 lamellar (53,8%), 19 - penetrating (10,9%), biological covering according Puchkovskaya - 43 (24,3%), mushroom grafts or two grafts keratoplasty 18 (9,3%). Preoperative visual acuity was in 82,3% eyes £0,02. Follow-up period was in average 25,8±SD3,2 months.
Results: Therapeutic success achieved in 98,8% eyes. The average postoperative best corrected visual acuity after TKP was 0,17±SD0,12. The main complication were: graft rejection -35,4%, cataract progression -21,8%, secondary glaucoma -17,3%, graft melting -7,5%, graft infection -6,4%. Repeated KP with optical purpose performed after 9-13 months in 43 eyes, combined with cataracta extraction in 3 eyes, triple procedure in 7 eyes. Visual acuity improved in 124 eyes (71,6%), among them 0,1-0,6 - in 31 eyes (25,0%).
Conclusions: Therapeutic keratoplasty is an effective method of treatment patients with severe corneal inflammatory diseases of different etiology. Efficiency of TKP depends on timely operation perfomance and a choice of surgical tactics.
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