Sclerokeratoplasty versus penetrating keratoplasty in anterior staphyloma.

Background And Objective: To assess the efficacy of the newer surgical technique of sclerokeratoplasty in spherical anterior staphyloma of the cornea and to compare it with total penetrating keratoplasty.

Patients And Methods: A randomized, prospective clinical trial in 20 eyes with acquired spherical anterior staphylomas was undertaken. Ten eyes each underwent sclerokeratoplasty (group 1) or total penetrating keratoplasty (group 2). The parameters evaluated were visual acuity, keratometry, graft status, and complications. Patients were observed for a minimum of 1 year.

Results: Best spectacle-corrected visual acuity of 6/60 or better with astigmatism of less than 3 D was achieved in all but one patient in group 1 in contrast to 5 cases in group 2. Postoperative complications included epithelial defects, shallow anterior chamber, hyphema, and uveitis, which did not significantly vary between the 2 procedures. Secondary glaucoma was significant associated with group 2 as compared with group 1. At the end of 1 year, no significant difference in the graft clarity was present. Grafts were clear 3+ or more in 8 eyes in group 1 and in 5 eyes in group 2. Good cosmetic results were achieved in cases of sclerokeratoplasty due to the absence of corneal opacification and suture marks.

Conclusion: Sclerokeratoplasty is a useful alternative to total penetrating keratoplasty in cases of acquired spherical anterior staphylomas of the cornea with good anatomic and useful visual outcome.