Two Cases of Boston (Dohlman-Doane) Type I Keratoprosthesis

PURPOSE: This article reports two cases of Boston (Dohlman-Doane) Type I Keratoprosthesis procedures that were performed for the first time in Korea. METHODS: Using the Boston Type I keratoprosthesis, we implanted ultimately these to two cases of corneal blinded patients. RESULTS: Two Boston (Dohlman-Doane) Type I Keratoprosthesis procedures were performed successfully. The first case had poor visual prognosis due to preexisting optic neuropathy and vitreous hemorrhage, but was showed better for cosmetic effect. The second case had maintained an uncorrected visual acuity of 0.1 at postoperative 3 months. CONCLUSIONS: We hope to perform additional procedures and long-term follow-ups to further evaluate this new surgical technique for stability and efficiency.

Microbiologic Study of Imported Donor Corneas and Preserved Solutions

PURPOSE: To evaluate the prevalence of contamination of imported donor corneas and their preserved solutions, and to characterize the spectrum of contaminating microorganisms. METHODS: Thirty-seven imported donor corneas and their preserved solutions imported between December 2003 and June 2005 were included in this study. RESULTS: Five imported donor corneas (13.5%) had positive bacterial cultures, and none had positive fungal or mycobacterial cultures. On the other hand, the preserved solutions did not have positive bacterial, fungal, or mycobacterial cultures. One of the 5 imported donor corneas with positive bacterial culture had a mixed bacterial culture. There were 3 isolates of Staphylococcus epidermidis, 1 isolate of Streptococcus viridans, 1 isolate of Enterobacter cloacae, and 1 isolate of Pseudomonas aeruginosa. CONCLUSIONS: The prevalence of contamination of imported donor corneas is low; however, there is a risk of postkeratoplasty infection by contaminated donor corneas. Thus, careful management should be practiced during and after corneal transplant operations.

Results of Scleral Allografting on Scleral Necrosis Following Pterygium Excision

PURPOSE: To emphasize the importance of conjunctival flap or amniotic membrane covering on the scleral allograft for scleral necrosis following pterygium excision. METHODS: Five eyes in four patients showed signs of impending perforation caused by scleral necrosis following pterygium excision, with strontium irradiation in four eyes and with instillation of mitomycin C in the other eye for preventing recurrence of pterygium. All cases were transplanted human sclera stored at -20 degrees C in Eye-Bank. Among them, the patient's own conjunctiva was used to cover the scleral allograft with interrupted sutures in four eyes, where in the other eye the scleral allograft was alternatively covered over by using human amniotic membrane stored at -70 degrees C. RESULTS: The results of all five cases were very successful without any complications during an average follow-up of 19 months (range 6~25 months). CONCLUSIONS: Based on the clinical experiences of these five cases, we concluded that the covering of the scleral allograft with conjunctiva or amniotic membrane is a very important procedure to ensure the successful viability of the scleral allograft, which is a natural structure of the conjunctiva and sclera.