The graft survival evaluation after subtotal penetrating keratoplasty in the long-term postoperative period

Abstract

Introduction. Until the 2000s, in diseases leading to corneal blindness, it was expediently to perform subtotal keratoplasty in order to provide an organ-sparing effect and restore visual functions. Such procedures were not widely spread due to a great number of problems; they were performed with extended depressurization of the eye, and had a high risk of intraoperative complications. Nowadays, many ophthalmologists face the remote consequences of subtotal keratoplasty. Aim. The purpose is to evaluate the transplant after subtotal penetrating keratoplasty (SPK) and visual functions in the remote postoperative period. Materials and methods. We have examined 14 patients (14 eyes), aged from 28 to 81 years, at 6-10 years after SPK. Visual acuity (VA) testing, autorefractometry and confocal microscopy (Confoscan 4) were performed. Results. According to visual acuity testing results, patients were divided into 3 groups: 1st group with high VA (more than 0.2 - in 7.2% of patients), 2nd group with medium VA (from 0.2 to 0.005 - in 21.4% of patients), and 3rd - low VA (less than 0.005 - in 71.4% of patients). Before the SKP, VA was 0.004-0.7. After the SKP, the indices varied from light sensation with correct light projection to 1.0. High rate was in 21.5%, medium - in 35.7%, low in 42.8% of cases. According to autorefractometry data, the cylindrical component was in average 6.5 ± 3.0. Most often, astigmatism was revealed in the low (up to 3) and high degree (more than 6). According to confocal microscopy data, the average density of endothelial cells was 1700 ± 50 cells/mm2. Conclusion. More than a half of patients has preserved good visual functions and a transparent transplant at 6-10 years after the SKP, and this significantly improves the quality of patients´ life. (For citation: Berdieva NN, Shapovalova EV, Riks IA. The graft survival evaluation after subtotal penetrating keratoplasty in the long-term postoperative period. Ophthalmology Journal. 2017;10(3):22-28. doi: 10.17816/OV10322-28).