Techniques in Penetrating Keratoplasty

Sugar, Alan; Sugar, Joel

doi:10.1097/00003226-200009000-00005

Cited by 57 publications

(9 citation statements)

References 119 publications

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“…This trend has also been observed in other centers and Sugar and Sugar reported that failed graft surpassed other indications for PK at both of their institutions for the last 100 cases that they each performed in the 1990s. 3,5,[9][10][11] However, PBK/ABK was the most common indication for PK at our institution during the earlier time intervals of 1980-1981 and 1990-1991. In addition, several institutions listing PBK as their leading indication for PK reported a decreasing trend in its incidence. 12,13 The reason for this gradual decline in the incidence of PBK/ABK with PKs over the length of our study was most likely due to better surgical techniques, improved intraocular lenses, and the extensive use of viscoelastics.…”

Section: Discussionmentioning

confidence: 90%

Trends in the Indications for Penetrating Keratoplasty, 1980-2001

Kang

Klintworth

Kim

et al. 2005

Cornea

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Section: Discussionmentioning

confidence: 90%

Trends in the Indications for Penetrating Keratoplasty, 1980-2001

Kang

Klintworth

Kim

et al. 2005

Cornea

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“…The only solution for this dysfunction over the past 100 years has been penetrating keratoplasty (PK) 1. Penetrating keratoplasty is considered as the gold standard for treating corneal decompensation from endothelial dysfunctions but its disadvantages are well known 2.…”

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confidence: 99%

Descemet stripping and endothelial keratoplasty in endothelial dysfunctions: Three-month results in 75 eyes

Basak¹

2008

Indian J Ophthalmol

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Purpose:To analyze the results of Descemet stripping and endothelial keratoplasty (DSEK) in the first consecutive 75 cases.Materials and Methods:Prospective, non-randomized, non-comparative interventional case series. Seventy- five eyes of 75 patients with endothelial dysfunctions of different etiology, scheduled for DSEK, were included in this study. Healthy donor cornea with a cell count of >2000 cells/sq mm was considered for transplantation in each case. Indications, operative problems and postoperative complications were noted. Best corrected visual acuity (BCVA), refractive and keratometric astigmatism, central corneal thickness (CCT) and endothelial cell density (ECD) were analyzed for each patient after a minimum follow-up of three months.Results:Main indication was pseudophakic corneal edema and bullous keratopathy in 53 (70.7%) eyes. Seventeen (22.7%) cases had moderate to severe Fuchs′ dystrophy with various grades of cataract; and DSEK was combined with manual small-incision cataract surgery (MSICS) with posterior chamber intraocular lens (PCIOL) in those cases. After three months, BCVA was 20/60 or better in 62 (82.7%) cases. Mean refractive and keratometric astigmatism were 1.10 ± 0.55 diopter cylinder (DCyl) and 1.24 ± 0.92 DCyl. The CCT and ECD were 670.8 ± 0.32 µm and 1485.6 ± 168.6/sq mm respectively. The mean endothelial cell loss after three months was 26.8 ± 4.24% (range: 13.3-38.4%). Dislocation of donor lenticule occurred in six (8.0%) eyes. Graft failure occurred in one case.Conclusions:Descemet stripping and endothelial keratoplasty is a safe and effective procedure in patients with endothelial dysfunctions with encouraging surgical and visual outcomes. It can be safely combined with MSICS with PCIOL in patients with moderate to severe Fuchs′ dystrophy with cataract.

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“…Пациентка Ма (рис. 5,6). НКОЗ = 0,4, КОЗ = 0,4, ЦТР = 605 мкм, ПЭК = 1194 кл/мм 2 , толщина трансплантата в центре -81 мкм, в периферической зоне -89 мкм, ИЦК = 0,91.…”

Section: результатыunclassified

“…Автоматизированная задняя послойная кератопластика (ЗАПК), также известная как DSAEK (Descemet's Stripping Automated Endotelial Keratoplasty) -«золотой стандарт» лечения эндотелиальной дистрофии роговицы Фукса и БК, однако наиболее высокие зрительные функции можно получить только при использовании так называемого ультратонкого трансплантата, центральная толщина которого не превышает 130 мкм [3][4][5][6]. По данным K.D.…”

Section: Introductionunclassified

Inverted Posterior Femto-Keratoplasty: Quality of the Surface of the Corneal Section and Preliminary Clinical Outcomes

et al. 2020

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Purpose. To evaluate the quality of the surface of an ultra-thin donor transplant prepared from the endothelial surface of the cornea using a femtosecond laser and to demonstrate the preliminary clinical results. Patients and Methods. 4 eyes were operated: 3 with Fuch`s endothelial dystrophy and 1 with pseudophakic bullous keratopathy. All patients were treated with DSEK with an ultrathin graft prepared by Alcon Wavelight FS 200 femtosecond laser (Germany). Before and after surgery UCVA, BSCVA, astigmatism, ECD were measured. EC death, graft thickness and CCT were evaluated at 12 months` observation. Atomic force microscopy was used for examination of 10 samples. Control group was 5 corneal flaps obtained by mechanical microkeratome (Moria SLK-2, France). Main group — 5 corneal flaps, obtained by femtosecond laser. Nonparametric Mann-Whitney test was used for statistical analysis. Coefficient of reliability p < 0.05 was considered to be significant. Results. RMS value of femto-laser group samples was 18.6 ± 7.8 um. RMS of microkeratome group samples was 22.3 ± 18.3 um. Statistical analysis did not reveal significant differences between the values of the studied parameter in these groups (p > 0.05). Transparent engraftment was observed in all cases, no corneal edema was identified. BSCVA ranged from 0.2 to 0.6, which was associated with the presence of concomitant pathology. Astigmatism was 1.35 ± 1.0 D. ECD = 1526 ± 434 cells/mm2. EC loss = 48.0 ± 12.8 %. Graft thickness in the central zone was 78.0 ± 18.1 µm. Center-Edge Index — 0.84 ± 0.12. CCT = 600 ± 31 um. No postoperative complications were found. Conclusion. The developed settings allowed to obtain high-quality ultra-thin graft with a sufficiently uniform surface without a risk of perforation. Preliminary clinical results showed the method potential for restoration of corneal transparency. ECD loss corresponded to the one achievable by DSAEK.

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Techniques in Penetrating Keratoplasty

Cited by 57 publications

References 119 publications

Trends in the Indications for Penetrating Keratoplasty, 1980-2001

Trends in the Indications for Penetrating Keratoplasty, 1980-2001

Descemet stripping and endothelial keratoplasty in endothelial dysfunctions: Three-month results in 75 eyes

Inverted Posterior Femto-Keratoplasty: Quality of the Surface of the Corneal Section and Preliminary Clinical Outcomes

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