"Tuck in" lamellar keratoplasty for tectonic management of postkeratoplasty corneal ectasia with peripheral corneal involvement.

Abstract

PURPOSE:

Evaluation of "tuck in" lamellar keratoplasty (TILK) for the surgical management of postkeratoplasty corneal ectasia with peripheral corneal involvement.

METHODS:

Four eyes of 3 patients with post-penetrating keratoplasty corneal ectasia and contact lens intolerance underwent TILK that included a central lamellar keratoplasty with intrastromal tucking of the peripheral flange, at the Royal Victorian Eye and Ear Hospital, Melbourne, Australia. The main outcome measures analyzed were uncorrected visual acuity, best-corrected visual acuity, keratometry, and endothelial cell density.

RESULTS:

The original indication for surgery was keratoconus in all the cases. TILK was successfully performed in these patients. Mean follow-up period was 13 months (SD: 7.74) (range: 6-24 months). The preoperative best-corrected visual acuity improved from a mean value of 0.05 (SD: 0.05) to 0.34 (SD: 0.03) (P < 0.001). Mean keratometry decreased from 59.67 diopter (SD: 7.18) preoperatively to 43.50 diopter (SD: 2.23) postoperatively (P < 0.005). Mean endothelial cell loss after TILK was 5.93% (SD: 3.06) (P < 0.206). All grafts were clear at the last follow-up, and no cases of stromal or endothelial graft rejection were encountered.

CONCLUSIONS:

TILK can be successfully performed for post-penetrating keratoplasty corneal ectasia with peripheral corneal thinning.

• Authors: Rasik B Vajpayee, Vishal Jhanji, Jacqueline Beltz, Sonia Moorthy
• Journal: Cornea (Cornea) Vol. 30 Issue 2 Pg. 171-4 (Feb 2011) ISSN: 1536-4798 [Electronic] United States
• PMID: 21045672 (Publication Type: Journal Article)

Topics

• Adolescent
• Adult
• Cell Count
• Child
• Cornea (pathology)
• Corneal Diseases (etiology, pathology, physiopathology, surgery)
• Corneal Transplantation (methods)
• Endothelium, Corneal (pathology)
• Eyeglasses
• Humans
• Keratoconus (surgery)
• Keratoplasty, Penetrating (adverse effects)
• Reoperation
• Retrospective Studies
• Visual Acuity
• Young Adult