Posters

Corneoscleral transplantation and cataract extraction for end stage of acanthamoeba keratitis. A case report

Poster Details

First Author: I.Iskakov RUSSIA

Co Author(s):                        

Abstract Details

Purpose:

To assess safety and efficiency of new technique for surgical treatment of end stage infectious corneal disease.

Setting:

S. Fyodorov Eye Microsurgery Federal State Institution, Novosibirsk Branch, Russia

Methods:

Contact lens wearer with recurrent acanthamoeba keratitis of both eyes after LKP, PKP x3, secondary cataract - OD, PKP, closed vitrectomy - OS within 2,5 year of disease onset. Medical therapy wasn’t effective. OD had light perception with projection, OS without projection. Sclera of donor globe was cut by 16,0 mm trephine. Corneoscleral graft was separated by blunt spatula. Perytomy, dissection of recipient cornea and extracapsular cataract extraction were performed. The graft was first fixated with four mattress sutures (through the recipient corneal lip), with 16 interrupted sutures around scleral rim. Conjunctiva was fixed to the limbus of the graft.

Results:

No intraoperative or postoperative complications were noted. Soft contact lens for promoting full reepithelization was used long time after surgery. The conjunctival sutures were deleted in one month after surgery. Immune suppression with systemic cyclosporin A and additional steroids was performed. Transplanted corneoscleral graft was transparent during 6 months follow-up. Uncorrected distant Snellen VA of right eye was 0,3 and corrected one (sph 4,0 cyl 3,5 ax 130) was 0,5. The minimum thickness of transplanted cornea controlled by coherent optical tomography was 534 micron. The average density of endothelial cells of transplanted cornea was 1811 cells/mm2. Intraocular pressure was normal.

Conclusions:

New approach of surgical treatment in patients with end stage of acanthamoeba keratitis was approved. The proposed method of cutting a corneoscleral transplant with full thickness scleral rim and its fixation to the recipient's eye using mattress sutures is a simple, safe and effective procedure.

Financial Disclosure:

None