ABSTRACT
PURPOSE: To evaluate the results of posterior lamellar keratoplasties (DMEK and PDEK) in phakic eyes. MATERIAL AND METHODS: Retrospective analysis of surgeries performed in our department between June 2016 and December 2019. The main focus was put on postoperative visual acuity, corneal endothelial cell density and possible peroperative and postoperative complications including cataract formation. RESULTS: We performed 12 surgeries on 11 eyes of 7 patients. The most prevalent primary diagnosis was Fuchs endothelial dystrophy (7 eyes), followed by bullous keratopathy after phakic anterior chamber IOL implantation (2 eyes) and ICE syndrome (2 eyes). The average length of follow-up was 12.5 months. Clinically significant complicated cataract had developed and was removed in 3 eyes, one eye required rebubbling due to graft detachment and one eye required rePDEK due to graft failure. At the end of follow-up, the average visual acuity was 0.87, while 82% of eyes achieved VA 0.8 or better, and the average endothelial cell density was 1589 cells/mm2. CONCLUSION: Posterior lamellar keratoplasties (DMEK and PDEK) can be performed on phakic eyes. When performed by an experienced surgeon, these are safe procedures with good postoperative results and significant advantage in preserving younger patients accommodation.
Subject(s)
Descemet Stripping Endothelial Keratoplasty , Fuchs' Endothelial Dystrophy , Descemet Stripping Endothelial Keratoplasty/methods , Endothelium, Corneal , Fuchs' Endothelial Dystrophy/surgery , Humans , Retrospective Studies , Visual AcuityABSTRACT
Some of the modifications of posterior lamellar keratoplasty is at the present considered by most of the corneal surgeons as method of choice in case of patients corneal endothelium damage. However, this surgical technique undergoes in the last 20 years relatively rapid development. Even in the current time, there exist side by side and are used different types and modifications of this sort of transplantation. Because of this reason, differences among individual methods are sometimes not accurately understood and the terminology may be used not exactly as well. The authors specify all until now described surgical methods, describe differences among single surgical procedures, and point out their advantages and disadvantages. The methods are described in the same order as they were historically introduced into the literature.Key words: posterior lamellar keratoplasty, surgical methods.
Subject(s)
Corneal Diseases/history , Corneal Transplantation/history , Corneal Transplantation/methods , Corneal Diseases/surgery , Endothelium, Corneal/pathology , Endothelium, Corneal/surgery , History, 20th Century , History, 21st Century , HumansABSTRACT
PURPOSE: to present one and two years clinical results after intrastromal continuous corneal ring implantation in keratoconus patients. METHODS: Retrospective evaluation of the results of patients with keratoconus, after MyoRing implantation for improving of visual functions. The uncorrected distance visual acuity (UDVA), best corrected distance visual acuity (CDVA), the residual subjective refractive error, pachymetry, keratometry and the size of corneal astigmatismus were evaluated. Peroperative and postoperative complications were investigated. The minimal follow-up time was 12 months. RESULTS: The study included 32 eyes of 30 patients with mean age of 30.08 (± 11.56) years. UDVA improved from 1.03 (± 0.41) logMAR to 0.36 (± 0.25) logMAR 12 months and 0.31 (± 0.27) logMAR 24 months after surgery. These changes were stastistically significant. The maxima value of corneal curvature (Kmax) was preoperatively 52.48 (± 6.35) D, 46.08 (± 4.44) D 12 months and 45.53 (± 5.52) D 24 months after surgery. Both changes were statistically significant (P Ë 0,00000). The mean value of corneal curvature (K mean) was preoperatively 50.10 (± 4.96) D, 44.25 (± 4.40) D 12 months and 44.11 (± 5.38) D 24 months after surgery. Both changes were statistically significant. In any of the patients we did not register any severe peroperative or postoperative complication. CONCLUSION: The MyoRing implantation is an effective and safe method in improvement of visual functions in keratoconus patients. Clinical results are stable in one and two years follow-up time.