Graft-size selection and anisometropia reduction in penetrating keratoplasty (PKP)

Autor: William J. Feuer, Ellen H. Koo, Richard K. Forster
Rok vydání: 2019
Předmět:
Male
genetic structures
Medical Doctors
Polymers
medicine.medical_treatment
Health Care Providers
Penetrating Keratoplasty
Anisometropia
Cornea
0302 clinical medicine
Suture (anatomy)
Medicine and Health Sciences
Myopia
Medical Personnel
Materials
Dioptre
Aged
80 and over
Visual Impairments
Multidisciplinary
Eye Lens
medicine.diagnostic_test
Ophthalmic Procedures
Middle Aged
Corneal topography
3. Good health
Chemistry
Professions
medicine.anatomical_structure
Macromolecules
Physical Sciences
Medicine
Female
Anatomy
Research Article
medicine.medical_specialty
Science
Ocular Anatomy
Materials Science
Surgical and Invasive Medical Procedures
03 medical and health sciences
Ocular System
Ophthalmology
Statistical significance
Physicians
medicine
Humans
Reduction (orthopedic surgery)
Aged
Retrospective Studies
Surgeons
business.industry
Corneal Topography
Biology and Life Sciences
Retrospective cohort study
medicine.disease
Polymer Chemistry
eye diseases
Health Care
Nylons
Keratoplasty
People and Places
030221 ophthalmology & optometry
Eyes
Population Groupings
business
Head
030217 neurology & neurosurgery
Keratoplasty
Penetrating
Zdroj: PLoS ONE
PLoS ONE, Vol 14, Iss 6, p e0218199 (2019)
ISSN: 1932-6203
Popis: PurposeTo compare the amount of myopia induced by same-size donor-to-host penetrating keratoplasty with that of the amount of myopia induced by over-sized donor-to-host penetrating keratoplasty.SettingTertiary referral academic center.DesignRetrospective cohort study.MethodsCharts from patients who underwent penetrating keratoplasty by the same technique at Bascom Palmer Eye Institute between Nov 1, 2002, and January 1, 2006, were reviewed. The patients underwent optical penetrating keratoplasty using 12 interrupted 10-0 nylon sutures and a 12-bite continuous 10-0 nylon suture by a single surgeon (R.K.F.). The surgical technique used would be considered standard of care at most institutions. The Institutional Review Board, University of Miami Human Subjects Research Office, approved the study protocol. The donor graft was over-sized by 0.25mm in eyes when the intended final refractive target was greater than -1.00 diopters spherical equivalent (SE). The same-size donor graft was used when the intended final refractive target was less than -1.00 diopters SE. The selection of donor graft size was entirely based upon clinical parameters, meaning that the intended final refractive target was determined per each patient's fellow eye refraction, with the intention of reducing anisometropia. All patients received postoperative refraction and corneal topography. These measurements were performed at 6-8 weeks when the initial removal of sutures commenced, then at 6 months, then after completion of selective suture removal, then again at 12 months.ResultsAt 12 months, the over-sized group resulted in -1.35 diopters (SD = 2.25) SE of refraction, and the same-size group resulted in -0.14 diopters (SD = 2.42) SE. This approached statistical significance (p = 0.052) in comparison to -1.00 diopters spherical equivalent.ConclusionsUsing a donor graft that is over-sized by 0.25mm results in refraction of -1.00 diopters SE or more of myopia. Using a same-size donor-graft results in refraction of less than -1.00 diopters SE. Therefore, careful graft-size selection can result in a more favorable clinical outcome-namely, reduction in anisometropia-in patients undergoing penetrating keratoplasty.
Databáze: OpenAIRE
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