Four year results of thick graft endothelial keratoplasty in a patient with brittle cornea syndrome: a new approach for keratoglobus

Session Details

Session Title: Cornea Surgical I

Session Date/Time: Monday 15/09/2014 | 08:00-10:30

Paper Time: 08:55

Venue: Boulevard B

First Author: : J.Hasanov AZERBAIJAN

Co Author(s): :    N. Hasanova   E. Gasimov           

Abstract Details

Purpose:

To evaluate the efficacy of first use thick graft-Descemet stripping endothelial keratoplasty in a patient with advance keratoglobus.

Setting:

Zarifa Aliyeva National Eye Center, Baku, Azerbaijan. Cornea and anterior segment department.

Methods:

We reported of a 5 year old girl with brittle corneal syndrome presented to Zarifa Aliyeva National Eye Center in April 2010. Hydrops (right eye) secondary traumatic Descemet’s membrane detachment underwent Descemet stripping endothelial keratoplasty. The large (9.5 mm in diameter) and thick (400 ± 27 μm) donor endothelial lenticule was used for the procedure. Visual acuity, refraction, keratometry, intraocular pressure, fundus examination, recipient and graft corneal thickness was measured before surgery and during 48 months follow up. For monitoring and quantification of the dynamics of the recipient and recipient/donor corneal response was used anterior segment ocular coherent tomography.

Results:

The mean central corneal thickness was 327 μm on right eye (edema 4+) and 260 μm on left eye preoperatively. Intraocular pressure in both eyes was within normal limits before and after surgery. Best corrected visual acuity on right eye light perception and left eye 0.1. Postoperative one week, 1, 6, 12, 24, 36, 48 months mean CCT in right eye was 631 μm, 437 μm, 421 μm, 416 μm, 427 μm, 450 μm, 453 μm, 450 μm, 448 μm. Cornea was completely clear at 3 weeks. Visual acuity was 0.08 Mean central donor: recipient: recipient/donor corneal thickness (from 3 to 48 months period) was 175.333±5.889: 260.333±9.667: 437.857±14.163 respectively. Visual acuity was stable (Vis = 0.15), corneal clear, and no episode of graft rejection was observed.

Conclusions:

To the best of our knowledge, this case is the first documented. Thick graft-Descemet stripping endothelial keratoplasty may be acceptable technique for providing tectonic tissue support, visual recovery, stabilizing eyes with advance keratoglobus, reducing myopia power and graft failure rate.

Financial Interest:

NONE