8.5/8.6-mm Excimer Laser-Assisted Penetrating Keratoplasties in a Tertiary Corneal Subspecialty Referral Center: Indications and Outcomes in 107 Eyes.

Abstract

PURPOSE:

To report the indications and outcomes of 8.5/8.6-mm excimer laser-assisted penetrating keratoplasties (PKPs) at a tertiary corneal subspecialty referral center.

METHODS:

This retrospective, descriptive, observational study included 107 PKPs performed in 96 patients (mean age, 53 ± 12 years). The patients' indications for surgery, best-corrected visual acuity, surface regularity index, surface asymmetry index, topographic astigmatism, central endothelial cell density, central corneal thickness, and graft status were recorded preoperatively, 6 weeks postoperatively, and before (12 ± 2 months) and after (19 ± 4 months) the suture removal.

RESULTS:

The surgeries included 48 primary PKPs and 59 repeat PKPs. The main indications were corneal ectatic disorders (50%), severe corneal keratitis (21%), and corneal scars (16%) in the primary PKP group and highly irregular astigmatism after PKP (51%) and previous graft decompensation (37%) in the repeat PKP group. From preoperative measurements to the last follow-up visit without sutures, we found significant improvements (P < 0.001 for all) in visual acuity (0.7 ± 0.3 LogMAR to 0.3 ± 0.2 LogMAR), surface regularity index (1.5-1.0), and surface asymmetry index (2.59-1.1). At the last follow-up, the mean outcome measurements did not significantly differ between the primary and repeat PKP groups. Overall, 89 grafts (83%) remained clear at the last follow-up.

CONCLUSIONS:

In cases of ectatic disorders and highly irregular astigmatism after keratoplasty, 8.5/8.6-mm excimer laser-assisted PKP seems to be an excellent treatment option, achieving a significant improvement in visual acuity.

• Authors: Raul Alfaro Rangel, Nóra Szentmáry, Sabine Lepper, Loay Daas, Achim Langenbucher, Berthold Seitz
• Journal: Cornea (Cornea) Vol. 39 Issue 7 Pg. 806-811 (Jul 2020) ISSN: 1536-4798 [Electronic] United States
• PMID: 32265385 (Publication Type: Journal Article, Observational Study)

Topics

• Cornea (diagnostic imaging, surgery)
• Corneal Diseases (diagnosis, surgery)
• Corneal Topography
• Female
• Humans
• Keratoplasty, Penetrating (methods)
• Lasers, Excimer (therapeutic use)
• Male
• Middle Aged
• Referral and Consultation
• Retrospective Studies
• Treatment Outcome
• Visual Acuity