Evaluation of the Cornea and Anterior Chamber Morphologic Changes After Penetrating Keratoplasty in Patients With Keratoconus

Ort, Abdulkadir; Güneş, Alime; Kandemir, Baran; Calısır, Kenan; Kalaycı, Mustafa; Genç, Oğuzhan; Özertürk, Yusuf

doi:10.1097/icl.0000000000000260

Cited by 9 publications

(16 citation statements)

References 16 publications

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“…However, there should not have been big differences in tomographic data between the groups just after PK. For example, KC eyes tend to have deeper ACD, but postoperative normalization of ACD by PK has been reported 19 , 20 . Also, inferior graft thinning, which was observed only in KC group, should not have existed at the time of PK.…”

Section: Discussionmentioning

confidence: 99%

Risk factors and evaluation of keratoconus progression after penetrating keratoplasty with anterior segment optical coherence tomography

Yoshida

Toyono

Shirakawa

et al. 2020

Sci Rep

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To determine the risk factors and unique characteristics of keratoconus (KC) progression after penetrating keratoplasty (PK), anterior segment optical coherence tomography parameters were statistically analyzed in comparison with eyes undergoing PK for other diseases as a control. Ninety-one eyes maintaining clear PK grafts for over 10 years were divided into 2 groups according to the primary indication for PK (KC vs Others groups). Corneal thinning indicators (inferior host thinnest corneal thickness/central corneal thickness [IHT/CCT], inferior graft thinnest corneal thickness/CCT [IGT/CCT]), were smaller whereas anterior chamber depth, and steepest corneal power (Ks), and maximum corneal power (Kmax) were larger in the KC group with statistical significance. Graft size, Kmax and Ks correlated with IHT/CCT and IGT/CCT in the KC group. These correlations were not detected in controls. Graft size and postoperative period were selected by multivariate regression analysis as factors for corneal ectatic changes in the KC group. In conclusion, KC eyes long after PK show inferior graft and host corneal thinning, and corneal protrusion. Corneal power parameters such as Kmax or Ks can be used to monitor KC progression after PK. A small graft might lead to KC progression after PK.

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Section: Discussionmentioning

confidence: 99%

Risk factors and evaluation of keratoconus progression after penetrating keratoplasty with anterior segment optical coherence tomography

Yoshida

Toyono

Shirakawa

et al. 2020

Sci Rep

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“…ACD and keratometry values were reported to decrease signi cantly after PK due to tightened sutures, which straightened the cornea, and this effect increases with increased suture tension. 5 Onuchi et al…”

Section: Discussionmentioning

confidence: 99%

“…4 Both lamellar and penetrating keratoplasty procedures, which replace part of the recipient's corneal tissue with donor corneal tissue, may lead to signi cant anatomical changes to the cornea and anterior chamber structures. 5 Changes in the corneal thickness and curvature after corneal transplantation where corneal morphology is altered have an impact on IOP measurements. Lamellar techniques such as DALK and DMEK, which have additional stromal tissue and an interface between host and graft tissue, may have a different signi cance on IOP measurements in terms of corneal parameters.…”

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confidence: 99%

WITHDRAWN: Intraocular Pressure Changes Following Different Keratoplasty Techniques and Association with Cornea Parameters and anterior Chamber Depth

Gümüş¹,

Altan

Yıldırım

et al. 2021

Preprint

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Purpose To evaluate early intraocular pressure (IOP) changes following different keratoplasty techniques and to investigate the relationship between corneal thickness (CT), keratometry values, anterior chamber depth (ACD) and IOP changes. Methods We included patients who underwent penetrating keratoplasty (PK), deep anterior lamellar keratoplasty (DALK) and Descemet membrane endothelial keratoplasty (DMEK). ACD, CT, and keratometry measurements were repeated postoperatively at hour 24, week 1, and month 1. IOP measurements were repeated at postoperative hours 6 and 24, week 1, and month 1 by Tono-Pen XL. Results Twenty-two patients underwent PK, 12 patients underwent DALK, and 19 patients underwent DMEK. The difference between the IOP preoperatively and 6 hours postoperatively and between the IOP preoperatively and 24 hours postoperatively were statistically significant in the three types of surgery (p < 0.05 for each). The difference between preoperative and postoperative week 1 IOP was statistically significant only in the PK group (p = 0.023). When the IOP was compared between the three types of surgeries, the IOP at postoperative week 1 in the PK group was significantly higher than the DALK and DMEK groups (p = 0.021). There was no correlation between ACD, corneal thickness, K values, and IOP in any group. Conclusion IOP may increase in all types of keratoplasty during the first hours after surgery, but PK has a risk of high IOP longer in the early postoperative period. PK patients should be followed more carefully during postoperative week 1 to check for an increase in IOP.

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“…Although the trend of MSC change was obvious in the merged statistical analysis, comparisons among different keratoplasty types showed that PK led to more obvious morphological alterations compared with DALK on the first day after surgery. It was proved that the replacement of lamellar thickness of the corneal tissue of recipients causes less traction power to the corneoscleral tissue and anatomical changes to the anterior chamber angle when compared with full-thickness corneal tissue transplantation ( Ort et al, 2017 ). DALK preserves the intact Descemet’s membrane (DM) and endothelium.…”

Section: Discussionmentioning

confidence: 99%

“…With an incidence rate of 5.5–31%, ocular hypertension (OHT) or secondary glaucoma (SG) in the early postoperative period after penetrating keratoplasty (PK) may lead to endothelial dysfunction and graft failure ( Karadag et al, 2010 ; Ali et al, 2011 ; Kornmann and Gedde, 2016 ). Changes of anterior chamber parameters, including anterior chamber depth and volume and iridocorneal angle, were detected after keratoplasty ( Gatzioufas et al, 2012 ; Ort et al, 2017 ), yet the SC was not explored. Therefore, we hypothesized that keratoplasty-induced anterior chamber structural changes, especially in the morphology of SC, could cause early postoperative OHT.…”

Section: Introductionmentioning

confidence: 99%

Fourier-Domain Optical Coherence Tomographic Assessment of Changes in the Schlemm’s Canal of Nonglaucomatous Subjects After Keratoplasty

Zhao

Hong

et al. 2021

Front. Physiol.

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Purpose: This study aimed to evaluate the impact of keratoplasty on the in vivo anatomical structures in the Schlemm’s canal (SC) of nonglaucomatous subjects using Fourier-domain optical coherence tomography (FD-OCT).Methods: Sixty-six nonglaucomatous eyes that underwent penetrating keratoplasty (PK), deep anterior lamellar keratoplasty (DALK), or triple surgery were enrolled in this prospective, comparative, observational study. The SC imaging was performed using FD-OCT before and after surgery in both the nasal and temporal quadrants. Patient demographics, SC parameters [e.g., cross-sectional area (CSA), meridional diameter of SC (MSC), sagittal diameter of SC (SSC), and circumference (CCF)], and the correlations between the variation of SC parameters and intraocular pressure (IOP) were analyzed.Results: The mean age of all subjects was 40.27 ± 18.97 years. Among all cases, the nasal, temporal, and mean MSC significantly decreased on the first day after surgery and then increased at 1 week (p = 0.04, 0.017, and 0.01, respectively). Temporal CSA (tCSA), temporal MSC (tMSC), and temporal circumference (tCCF) after PK (p = 0.017, 0.020, and 0.018, respectively) and nasal MSC (nMSC) after DALK (p = 0.025) decreased significantly on the first day after surgery. The shift in mean IOP was significantly correlated with the changes in tMSC (r = 0.341, p = 0.003) and CCF (r = 0.207, p = 0.048).Conclusion: SC had significant in vivo morphological changes in the early period after keratoplasty in nonglaucomatous eyes, accompanied with elevation of IOP. Early intervention might be necessary to prevent secondary glaucoma early after keratoplasty.

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Evaluation of the Cornea and Anterior Chamber Morphologic Changes After Penetrating Keratoplasty in Patients With Keratoconus

Cited by 9 publications

References 16 publications

Risk factors and evaluation of keratoconus progression after penetrating keratoplasty with anterior segment optical coherence tomography

Risk factors and evaluation of keratoconus progression after penetrating keratoplasty with anterior segment optical coherence tomography

WITHDRAWN: Intraocular Pressure Changes Following Different Keratoplasty Techniques and Association with Cornea Parameters and anterior Chamber Depth

Fourier-Domain Optical Coherence Tomographic Assessment of Changes in the Schlemm’s Canal of Nonglaucomatous Subjects After Keratoplasty

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