Long-Term Outcomes of Two-Piece Mushroom Keratoplasty for Traumatic Corneal Scars
| Autor: | Massimo Busin, Rossella Spena, Federica Fabbri, Angeli Christy Yu, James Myerscough, Riccardo Dondi, Cristina Bovone, Fiorella Fusco |
|---|---|
| Rok vydání: | 2022 |
| Předmět: |
medicine.medical_specialty
Visual acuity genetic structures Visual Acuity Socio-culturale Glaucoma Astigmatism Refraction Ocular Corneal Transplantation Penetrating Ocular Ophthalmology medicine Long term outcomes Humans Endothelium Dioptre Corneal Scar business.industry Endothelium Corneal Corneal Postoperative complication medicine.disease eye diseases Endothelial cell density Refraction Treatment Outcome Keratoplasty medicine.symptom business Keratoplasty Penetrating Corneal Injuries |
| Zdroj: | American Journal of Ophthalmology. 236:20-31 |
| ISSN: | 0002-9394 |
| DOI: | 10.1016/j.ajo.2021.09.036 |
| Popis: | PURPOSE To report the outcomes of two-piece microkeratome-assisted MK for eyes with full-thickness traumatic corneal scars and otherwise functional endothelium following corneal penetrating injury. DESIGN Interventional case series METHODS: : In this single-center study, 41 consecutive eyes with traumatic corneal scars that underwent two-piece microkeratome-assisted mushroom keratoplasty were evaluated. The two-piece mushroom graft consisted of an anterior lamella of 9-mm diameter and a posterior lamella of 6-mm diameter. Outcome measures were best spectacle-corrected visual acuity (BSCVA), refractive astigmatism (RA), endothelial cell density and postoperative complication rates. RESULTS Of the 41 total cases, 38 eyes (93%) reached Snellen vision ≥20/100, 36 (88%) reached ≥20/60, 29 (71%) reached ≥20/40 and 13 (32%) reached ≥20/25 2 years following MK. Excluding eyes with vision-impairing comorbidities, baseline logMAR BSCVA (1.41±0.73) significantly improved annually during the first 2 years (p < 0.001) reaching 0.16±0.13 at year 2 which subsequently remained stable up to 10 years (p = 0.626). RA exceeded 4.5 diopters in 2 cases (5%) after wound revision for high-degree astigmatism in 5 cases. Endothelial cell loss was 35.1% at 1 year with an annual decline of 2.9% over 10 years. Elevation in IOP was observed postoperatively in 7 eyes of which 6 had pre-existing glaucoma. The 10-year cumulative risk for graft rejection and failure was 8.5% and 10% respectively. CONCLUSION Two-piece microkeratome-assisted MK for traumatic corneal scars can allow excellent visual rehabilitation with relatively stable ECL and low rates of immunologic rejection and graft failure. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect