NR 5/2003
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Zastosowanie głębokiej keratoplastyki
warstwowej w leczeniu schorzeń rogówki bez zmian w śródbłonku
Applying of deep lamellar keratoplasty in the corneal
disorders without endothelial abnormalities
Edward Wylęgała, Ewa Marta Wróblewska,
Dorota Tarnawska, Marzena Mierzwa
Z Oddziału Okulistycznego Okręgowego Szpitala Kolejowego w Katowicach
Ordynator: dr n. med. Edward Wylęgała |
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| Summary: |
Purpose: To present own experiences in the
surgery of deep lamellar keratoplasty.
Materials and methods: 25 eyes of 25 patients suffering from various
corneal pathologies with preserved endothelium: 22 with keratoconus eyes, 2 with
post-inflammatory scar and one eye with leucoma in Stevens-Johnson syndrome. Mean
follow-up was 25,5 months (from 6 to 32). Main outcome measures were Non-Corrected and
Best Corrected Visual Acuity (NCVA, BCVA), astigmatism, refractive error, IOP and corneal
transparency. The surgery was performed in general anesthesia. In majority of cases the
recipient stroma was trephined to a depth of 70% with 7,5 mm diameter vacuum trephine. In
cases of intraoperative perforation of Descemet membrane with shallow anterior chamber we
converted the procedure into penetrating keratoplasty. The donor lenticule was trephined
in the artificial chamber with the 0,5 mm oversized manual trephine to a depth of 90%. In
two cases after DLK was finished, limbal stem cell grafting was additionally performed.
Results: Postoperative NCVA ranged from 0,01 to 0,8 and BCVA from 0,1 to
0,8. Astigmatism ranged from 0,5 to 10,0 D. Refractive error ranged from -8,0 to +1,0 D.
In follow-up period all grafts maintened transparent. The complications were mainly
intraoperative perforations of Descemet membrane (9 cases): in 7 cases we convert the
procedure into penetrating keratoplasty. In 2 cases the double chamber forming was
observed: in one case on 7 day following surgery the penetrating keratoplasty was
performed, in other a spontaneous attachment was observed. We also observed loose sutures
in 2 cases, inflammatory infiltrates in one case. Two cases of ocular hypertension was
successfully treated by medication.
Conclusions: Deep lamellar keratoplasty is an effective procedure for
treating various diseases of corneal stroma with unaffected endothelium. |
| Słowa kluczowe: |
keratoplastyka warstwowa, głęboka keratoplastyka
warstwowa.
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| Key words: |
lamellar keratoplasty, deep lamellar keratoplasty. |
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