Acute keratoconus (acute KC), which affects approximately 1.6-2.8% of keratoconus (KC) patients, is a pathological condition of the cornea characterized by stromal edema due to entry of aqueous humor through a tear in Descemet's membrane. : We present a novel combination of surgical procedures that allows swifter visual recovery in a consecutive, retrospective case series. The new surgical procedure for acute KC consists of a combination of Muraine corneal sutures to smooth the corneal curvature and Excimer laser-assisted penetrating keratoplasty and was performed in six acute KC patients from 2019 to 2022 at the Department of Ophthalmology, University Hospital of Martin-Luther-University Halle-Wittenberg (UMH), Germany. We monitored data on preoperative status, operative details, intraoperative and postoperative complications and visual outcomes were analyzed. : The mean age was 41.5 13.5 years (3 OD, 3 OS). Neurodermatitis was present in 3 patients (50%). All patients received significant visual benefits from the procedure. Preoperative BCVA was hand motion (logMAR 3.0) in all patients; postoperatively, BCVA improved significantly logMAR 0.03 0.09 [range: 0.2-0.4; < 0.001, FUP 20+/-10 months). Visual acuity remained stable throughout the roughly biannual follow-ups. One patient developed endothelial graft rejection after 2 years. During the last examination, all eyes had clear grafts and stable curvatures, K1 and K2 being 42.43 ± 4.17 D and 44.95 ± 4.07 D, respectively, and mean corneal astigmatism was 2.61 ± 1.74 D. The thinnest corneal thickness was 519 ± 31 µm. A graft size of 8.0 × 8.1 mm was the most beneficial. : in patients with acute KC and hydrops, a penetrating keratoplasty with Muraine corneal sutures is successful in terms of graft clarity and visual outcome. Combining the procedures allows quicker visual recovery. Patients with a history of neurodermatitis should have preoperative and postoperative dermatologic treatment and close follow-up for possible complications.
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http://dx.doi.org/10.3390/jcm13133792 | DOI Listing |
Surv Ophthalmol
December 2024
Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
Systematic review and meta-analysis We assessed the efficacy of deep anterior lamellar keratoplasty (DALK) and penetrating (PK) for macular corneal dystrophy (MCD) We searched on 4 databases for articles published up to the end of April 2024. The study's outcome was postoperative visual acuity and other factors that may affect visual outcomes (e.g.
View Article and Find Full Text PDFInt J Ophthalmol
December 2024
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou 510060, Guangdong Province, China.
Aim: To investigate the efficacy of systemic mycophenolate mofetil (MMF) as an adjunct in combination with topical tacrolimus (FK506) and corticosteroid eyedrops for preventing corneal graft rejection after high-risk keratoplasty (HRK).
Methods: In this cohort study, 55 consecutive patients (55 eyes) from an eye center who met the criteria of HRK were included. The definition for HRK includes large grafts of no less than 9 mm diameter, vascularized cornea of two or more quadrants, regrafting, or eccentric grafts.
Int J Ophthalmol
December 2024
Department of Ophthalmology, General Hospital of Southern Theatre Command, Guangzhou 510010, Guangdong Province, China.
Aim: To assess the utility and efficiency of endoscopy-assisted vitrectomy (EAV) for the treatment of corneal opacity in severe ocular trauma.
Methods: Patients who underwent fundus examination using a preoperative slit lamp and intraoperative endoscopy, followed by EAV and additional surgery were retrospectively recruited. Silicone oil removal and penetrating keratoplasty were used in selected eyes at postoperative follow-ups.
J Clin Med
December 2024
Goldschleger Eye Institute, Sheba Medical Center, 5262000 Ramat Gan, Israel.
: To assess the long-term outcomes of combined penetrating keratoplasty (PKP) and pars plana vitrectomy (PPV). : A retrospective review of eyes that underwent combined surgery followed for 12 months or longer. Demographic data, indications for surgery, and pre-/post-surgical eye examinations were retrieved.
View Article and Find Full Text PDFJ Clin Med
November 2024
2nd Department of Ophthalmology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.
Intraocular pressure (IOP) readings using three different methods (Goldmann applanation tonometry (GAT), Corvis ST, and iCare) were compared in patients who underwent penetrating keratoplasty (PK). : An observational cross-sectional study with prospective recruitment of patients was conducted. IOP measurements were acquired using GAT, iCare, and Corvis (including both uncorrected IOP (CVS-IOP) and biomechanical IOP (bIOP)), and the agreement among methods was analyzed using Bland-Altman plots.
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