The purpose of this study was to report the long-term surgical and visual outcomes of patients with mucopolysaccharidoses (MPS) after big bubble deep anterior lamellar keratoplasty (BB-DALK).Methods: This was a retrospective case series of patients with MPS who underwent BB-DALK at a single academic institution. All patients had corneal clouding secondary to MPS limiting visual acuity for which keratoplasty was indicated. Each patient was evaluated and underwent surgery by a single surgeon. Reported data included age at keratoplasty, sex, MPS type, best spectaclecorrected visual acuity, change in pachymetry, ocular comorbidities, surgical complications, and MPS-related medication use.Results: Outcomes of 12 eyes from 7 patients with MPS type I (Hurler, Scheie, and Hurler-Scheie) are reported using the newest nomenclature. The mean follow-up was 5.58 years (range: 1-10 years). All cases underwent BB-DALK with a type 1 big bubble during the surgery. Two cases (16.6%) required rebubbling because of partial Descemet membrane detachment. One case was complicated by a suture abscess and required a penetrating keratoplasty. No episodes of rejection occurred. Statistically significant improvement in the best spectacle-corrected visual acuity (from a mean 0.85-0.33 logarithm of the minimum angle of resolution, P = logarithm of the minimum angle of resolution 0.0054) and pachymetry (mean reduction of 2145.4 mm, P = 0.0018) was observed.Conclusions: BB-DALK seems to be an acceptable long-term surgical option in patients with MPS. Our findings suggest that this technique is reproducible and can achieve clear corneal grafts with good visual results on a long-term follow-up.
Aim: This article reports the case of a patient with severe symptoms related to bad quality of vision after toric multifocal intraocular lens (IOL) that was diagnosed with mild keratoconus. Materials and methods:To present a case report and prospectively review of the literature, considering the relevance of screening ectaticconreal disease prior to refractive cataract (or lens) surgery. Results:The patient was dissatisfied, seeking a second opinion after the implantation of a toric multifocal IOL in the left eye. The IOL was properly centered and surgery had no complications. The preoperative refraction was −4.00 − 1.50 × 160, giving 20/40. Patient denied any history of keratoconus or transplant in his family. After cataract surgery, uncorrected distance vision acuity (UDVA) was 20/60, and J4 for near. Manifest refraction was + 2.00 − 0.50 × 130, giving 20/30. Corneal topography, tomography, and biomechanical assessments indicated the diagnosis of mild keratoconus. The patient was advised for IOL exchange, which was successfully done for a monofocal aspheric IOL. The patient was satisfied with the final result, presenting a final UDVA of 20/25, J3, and manifest refraction of +0.75 − 0.50 × 105, giving 20/20. Conclusion:Screening for corneal abnormalities including ectatic corneal disease is fundamental prior to the indication of a premium lens. Advanced corneal imaging plays a fundamental role to help select candidates for multifocal IOLs, as for individualized planning of refractive cataract surgery.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.