Two Cases of a Penetrating Keratoplasty With Tissue From a Donor Who Had Undergone LASIK Surgery

Michaeli‐Cohen, Adi; Lambert, Anelise Caron; Coloma, Fides; Rootman, David S.

doi:10.1097/00003226-200201000-00023

Cited by 33 publications

(19 citation statements)

References 7 publications

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“…3 In the literature, there are several case reports that emphasize the difficulty in using postrefractive surgery corneas in PK. 4 The corneal button excised from a post-LASIK donor poses problems both preoperatively and postoperatively. Intraoperatively, mistrephination, a split of donor cornea lamellae, and suturing difficulties have been reported.…”

Section: Discussionmentioning

confidence: 99%

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Rekeratoplasty for the Correction of Refractive Status Due to Post-LASIK Donor Graft

Yağcı

Palamar²,

Selver³

et al. 2022

Exp Clin Transplant

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We report a case of cataract-combined penetrating keratoplasty that required rekeratoplasty for refractive status because of the inadvertent use of a cornea from a donor who had undergone LASIK surgery. The case presents the use of perioperative visualization, anterior segment optic coherence tomography, and histopathologic confirmation. A 63-year-old female patient with leukoma and cataract in the left eye underwent combined cataract surgery and penetrating keratoplasty. During surgery, a jelly-like layer extending a few millimeters in diameter was observed around the lenticule. In addition, the graft was noticed to separate into 2 distinct layers, which were attributed to previous LASIK surgery. Optic coherence tomography of the postoperative anterior segment of the donor cornea also revealed a LASIK flap layer. Postoperative corneal topography displayed a power distribution of 46.8, 36.9, and 22.1 D at the 1.0-, 3.0-, and 7.0-mm corneal zones, respectively, and the best visual acuity did not improve. For this reason, rekeratoplasty was performed. Histopathologic evaluation of the excised button confirmed the presence of a LASIK flap. To the best of our knowledge, this case is the first report of penetrating keratoplasty that required rekeratoplasty due to refractive status. Perioperative discovery of a jelly-like layer due to a LASIK flap has also not been previously described. As the number of refractive surgeries increases, reliable, low-cost, and simple screening methods must be developed to more successfully detect postrefractive surgery tissue in the donor cornea supply.

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Section: Discussionmentioning

confidence: 99%

“…Intraoperatively, mistrephination, a split of donor cornea lamellae, and suturing difficulties have been reported. 4 Poor visual postoperative outcomes result mainly from a wide variation in refraction and keratometric values and induced hyperopia. These patients also have high risk of poor wound healing and flap dehiscence.…”

Section: Discussionmentioning

confidence: 99%

Rekeratoplasty for the Correction of Refractive Status Due to Post-LASIK Donor Graft

Yağcı

Palamar²,

Selver³

et al. 2022

Exp Clin Transplant

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“…Durante o procedimento cirúrgico, a tentativa de manter em posição as duas lamelas, pode requerer suturas mais apertadas, o que pode afetar a refração final. E, se as duas lamelas ficarem desalinhadas, poderá produzir aberrações ópticas e interferência com a transparência do botão (4) . O caso descrito apresenta botão transparente até o 6º mês pós-operatório.…”

Section: Discussionunclassified

“…No Brasil são realizadas cerca de 199.678 cirurgias refrativas por ano (2) , enquanto cerca de 200.000 americanos são submetidos a alguma forma de cirurgia refrativa anualmente (3) . A cirurgia refrativa em geral é realizada em pacientes entre 20-60 anos de idade, sendo esta faixa etária responsável por 25% das doações de córneas recebidas no Canadá (4) . Com o aumento do número de procedimentos refrativos no mundo, é de se esperar que os oftalmologistas se defrontem com córneas doadoras previamente submetidas a cirurgias de LASIK (laser assisted in situ keratomileusis), LASEK (laser assisted epithelial keratectomy) ou PRK (photorefractive keratectomy).…”

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Transplante de córnea com uso inadvertido de córnea de doador previamente submetido à cirurgia refrativa: relato de caso

Farias¹,

Parolim²,

Sousa³

2005

Arq. Bras. Oftalmol.

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“…[13][14][15] Such pathological grafts may cause complications during surgery and moreover impair the achievable visual outcome. 16,17 Supplementary screening methods are required which are able to visualize the structure of the corneal tissue and to calculate the surface topography or tomography. An objective, semiautomated screening method may assist standardization.…”

Section: Introductionmentioning

confidence: 99%

Optical coherence tomography-based topography determination of corneal grafts in eye bank cultivation

et al. 2017

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Abstract. Vision loss due to corneal injuries or diseases can be treated by transplantation of human corneal grafts (keratoplasty). However, quality assurance in retrieving and cultivating the tissue transplants is confined to visual and microbiological testing. To identify previous refractive surgery or morphological alterations, an automatic, noncontact, sterile screening procedure is required. Twenty-three corneal grafts have been measured in organ culture with a clinical spectral-domain optical coherence tomographer. Employing a biconic surface fit with 10 degrees of freedom, the radii of curvature and conic constants could be estimated for the anterior and posterior corneal surfaces. Thereupon, central corneal thickness, refractive values, and astigmatism have been calculated. Clinical investigations are required to elaborate specific donor-host matching in the future.

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Two Cases of a Penetrating Keratoplasty With Tissue From a Donor Who Had Undergone LASIK Surgery

Cited by 33 publications

References 7 publications

Rekeratoplasty for the Correction of Refractive Status Due to Post-LASIK Donor Graft

Rekeratoplasty for the Correction of Refractive Status Due to Post-LASIK Donor Graft

Transplante de córnea com uso inadvertido de córnea de doador previamente submetido à cirurgia refrativa: relato de caso

Optical coherence tomography-based topography determination of corneal grafts in eye bank cultivation

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