[Ipsilateral autorotational keratoplasty and cataract extraction in patients with trachoma and trauma in Oman. Report on visual rehabilitation].

Abstract

AIM:

To report on the results of visual rehabilitation by ipsilateral rotational keratoplasty (IRK) and cataract extraction in 17 patients with trachoma and with trachoma and trauma in Oman over 3 years.

PATIENTS:

Of 25 patients operated from 2001-2004 with IRK, extracapsular cataract extraction, and intraocular lens implantation, 17 eyes of 17 patients with cicatricial trachoma (WHO stage CO) could be followed up after 1 year. Group 1 comprised 11 eyes with ciatricial trachoma. In group 2, six eyes had additional traumatic corneal scars.

METHODS:

Surgery was performed using a motor trephine Keratron (Geuder), the Accurus 800 (Alcon) phacovitrectomy machine, and calculation for intraocular lens implantation (IOL: MZ60BD, Alcon) with a topography (Atlas, Humphrey Zeiss)-supported SRK II formula (OcuScanRxP, Alcon).

RESULTS:

Although only four of 17 patients had preoperative visual acuity (VA) at 5 m and one of 17 had VA at 1 m, postoperatively seven of 17 patients gained VA at 5 m and six of 17 at 1 m. Ambulatory vision was regained in 13 of 17 (78%) patients. Patients with trachoma and trauma benefited more from the surgery [vision increase in trachoma: eight of 11 eyes (73%); trachoma and trauma: five of five eyes (100%)]. Postoperative spherical refraction was -12.0D to +4.0D (median:+4.0D), and astigmatism ranged from 10D to 0.3D (median 5.35D). One eye was lost because of uncontrolled keratitis.

CONCLUSIONS:

IRK with cataract extraction may provide ambulatory vision in patients with cicatricial trachoma and secondary dry eye syndrome living in developing countries where donor grafts are difficult to obtain and where postoperative follow-up of high-risk keratoplasty is impaired.

• Authors: A A Bialasiewicz, U Wali, R Shenoy, A Thakral, N Al-Fadhil, G R Syed
• Journal: Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft (Ophthalmologe) Vol. 106 Issue 4 Pg. 340-5 (Apr 2009) ISSN: 1433-0423 [Electronic] Germany
• Vernacular Title: Ipsilaterale Autorotationskeratoplastik und Kataraktextraktion bei Patienten mit vernarbendem Trachom in Oman. Ein Erfahrungsbericht zur optischen Rehabilitation.
• PMID: 18622618 (Publication Type: Controlled Clinical Trial, English Abstract, Journal Article)

Topics

• Aged
• Aged, 80 and over
• Cataract Extraction (methods)
• Combined Modality Therapy
• Corneal Transplantation (methods)
• Eye Injuries (rehabilitation, surgery)
• Female
• Humans
• Lens Implantation, Intraocular (methods)
• Male
• Middle Aged
• Oman
• Trachoma (rehabilitation, surgery)
• Treatment Outcome