Tectonic penetrating keratoplasty and sclerokeratoplasty as treatment for perforated corneal ulcers of different aetiology
| Autoři | |
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| Rok publikování | 2010 |
| Druh | Konferenční abstrakty |
| Fakulta / Pracoviště MU | |
| Citace | |
| Popis | PURPOSE: To report the clinical outcomes in patient with herpetic, bacterial and autoimmune corneal ulcers treated by tectonic, centric or eccentric penetrating keratoplasty or by tectonic sclerokeratoplasty. DESIGN: Nonrandomized clinical trial. METHODS: The study included 37 patients (37 eyes) with perforated corneal ulcers consecutively operated by two surgeons. The main patients age was 62 years (SD 7). The patients were divided into 3 groups. Group A - keratolysis in herpes eye disease, 12 patients (32%), group B - keratolysis in autoimmune diseases (rheumatoid arthritis, Wegener granulomatosis 14 patients (37%) and group C - keratolysis in bacterial corneal ulcers 11 patients (31%). The time of observation was 12 to 42 months (SD 28). BCVA and immunologic graft rejection was assessed after 3 months. All patients have used systemic immunosupression CSA and MFM during 12 to 32 months(median 16). RESULTS: Values of BCVA were comparable during first 3 months in all groups, ranged from light perception to 0.4 (median 0.1). All transplants were clear, decreased visual acuity was due to cataract. In this period immunological graft rejection was not found in any group. After 12 month BCVA was in group A light perception to 0.1(median 0.01) in group B light perception to 0.1 (median 0.09), in group C light perception to 0.6 (median 0.1). Total immunological graft rejection after 12 month was found in group A in 100%, in group B in 50%and in group C in 15%. CONCLUSIONS: Tectonic penetrating keratoplasty is a treatment with uncertain results mainly in herpetic diseases of the eye. In other indications, such as bacterial ulcers and autoimmune systemic diseases, can keratolysis lead to good functional results. |
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