Abstract

SO.04.02

Long-term results of penetrating keratoplasty with cornea-prosthetic complex

Takchidi K. P., Moroz Z. I., Kalinnikov Y. Y., Kovshun E. V., Borzenok S. A.
S. Fyodorov Eye Microsurgery Complex, Moscow, Russia

Objective: To discuss long-term results in transplantation of cornea-prosthetic complex for thin vascular corneal leukomas.
Methods: In 1994 we have developed a new method of corneal burn leucoma treatment combining 2 types of surgical intervention: keratoplasty and keratoprosthetics. The corneal prosthetic complex is a disk of donor cornea with haptic plate and scleral rim stored in a special medium for 3 weeks. The goal of storage and preparation – is to treat the corneal button and to modify collagen fibers of corneal stroma, increase their rigidity and improve resistance to trypsin-like fractions of proteolytic lacrimal enzymes. The implant can be stored for 1 year and easily transported to other clinics. Penetrating corneal trepanation (9 mm) is carried out the patient’s eye and the cornea-prosthesis disk is fixated with an interrupted 8-0 Nylon sutures. The follow-up varied from 4 to 11 years.
Results: The cornea-prosthetic complex was implanted in 78 eyes with vascular leukomas. Visual acuity increased from light perception to 0,1-0,7. Complications included retroprosthetic membrane (13-16,6%), aseptic corneal necrosis (12-15,4%), endophthalmitis (1-1,2%), elevation of intraocular pressure (9-11,5%).
Conclusions: Penetrating keratoplasty with application of corneal prosthetic complex allowed us to reduce the number of surgeries in the eyes with thin vascular leukomas and to shorten the period of patient’s visual rehabilitation.

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