Penetrating Keratoplasty in Patients with Traumatic Corneal Scar

Abstract

BACKGROUND: To evaluate the results of penetrating keratoplasty (PK) due to trauma-related corneal scarring. METHODS: We evaluated 24 eyes of 24 patients who underwent PK due to trauma-related scarring of the cornea between May 2010 and June 2016. The postoperative visual acuity, graft transparency, and complications were evaluated. RESULTS: The patients were divided into two groups. In group 1, 14 eyes of patients with traumatic corneal scars and retinal detachment underwent PK, pars plana vitrectomy, and intravitreal silicone administration with the help of temporary keratoprosthesis. Group I included five females and nine males with an average age of 39.15±13.32 (min 8-max 73) years. An intraocular foreign body was removed from five of the eyes. The mean visual acuity was 3.01±0.013 (3.10-1.00) logMAR after the surgery, 1.36±0.23 (3.10-0.80) at the postoperative first month, and 1.18±0.03 (3.10-0.70) at the end of the first year after the removal of keratoplasty sutures. During the follow-up of patients, two eyes (14.2%) lost light sensation, eight eyes (57.1%) developed postoperative glaucoma, nine eyes (64.2%) had graft rejection, and one patient (7.1%) developed keratitis. In one eye (7.1%), the cornea was scraped using ethylenediaminetetraacetic acid due to silicone-related band keratopathy. In group 2, ten eyes with trauma-related corneal scars underwent PK. This group included two females and eight males with an average age of 29.23±12.03 (11-63) years. The mean visual acuity was 2.98±0.68 (3.10-1.00) logMAR before the surgery, 0.58±0.22 (1.80-0.30) at the postoperative first month, and 0.50±0.17 (1.80-0.10) at the end of the first year. One eye (10%) with iridodialysis developed glaucoma. Rejection was not seen in any of the patients. A statistically significant difference was observed in both groups with regard to visual acuity before operation, at 1 and 12 months after operation, and at 12 months for graft transparency rates (p=0.015, p=0.021, p=0.001, respectively). CONCLUSION: In cases of eye injuries due to trauma, the eyes subjected to combined vitrectomy and PK had poor visual prognosis and high graft rejection rate compared to those subjected to PK as the only treatment.

Оптимизация Лечения Травматических Кератитов

“…Несвоевременное, по ряду многих причин, удаление ИТ с поверхности роговицы может привести к развитию патологического процесса, который сопровождается развитием воспаления в слоях роговицы [8,17,19].…”