Optical-reconstructive surgery on the basis of penetrating keratoplasty in patients with iatrogenic ectasia of the cornea and combined diseases of the anterior segment of the eye

Session Details

Session Title: Presented Poster Session: Cornea: Surgical

Venue: Poster Village: Pod 3

First Author: : N.Senchenko RUSSIA

Co Author(s): :    T. Iureva                       

Abstract Details

Purpose:

To study the clinical effectiveness of combined optical-reconstructive interventions in the treatment of patients with severe iatrogenic ectasia of the cornea, combined with cataract and aniridia.

Setting:

S. Fyodorov Eye Microsurgery Federal State Institution, Irkutsk, Russia ISMAPgE – Branch Campus of the FSBEI FPE RMACPE MOH Russia

Methods:

Twelve patients aged 25 to 58 years with induced ectasia with significant corneal topography abnormalities after refractive surgery were operated. In all cases, corneal ectasia was combined with cataracts and in 3 patients with aniridia. Visual acuity before surgery ranged from 0.01 to 0.05 (0.02±0.05). Corneal thickness was on average 280±158 μm. Keratotopogram determined the uneven optical profile, the pronounced irregularity of astigmatism and the displacement of the corneal optical zone relative to visual axis. All patients underwent femtolaser-assisted penetrating keratoplasty and cataract phacoemulsification with elastic IOL implantation. In aniridia, an "artificial iris-IOL" monoblock was implanted during surgery.

Results:

The surgical results were evaluated by the frequency of transparent engraftment of the cornea with calculation of the density of endothelial cells and achieved visual functions 1 year after the surgery. Transparent engraftment 1 year after the surgery was noted in all patients. The average density of endothelial cells was 2264±115 cells/mm2. Loss of the density of endothelial cells of the graft varied from 18% to 32%. Practically in 10 times, in comparison with preoperative values, it was possible to increase visual functions - on the average 0,5±0,05 without correction and 0,8±0,02 with correction (p<0,001).

Conclusions:

The personalized approach to the treatment of patients with severe induced ectasia of the cornea, combined with other diseases of the anterior segment of the eye, allows effectively rehabilitating patients. The penetrating keratoplasty at that plays a key role, which ensures the normalization of the refractive indices of the eye and restoration of visual functions.

Financial Disclosure:

None