June 2015
Volume 56, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2015
OUTCOMES OF SCLERO-CORNEAL KERATOPLASTY IN SEVERE CORNEAL PERFORATIONS
Author Affiliations & Notes
  • Denise Loya
    Ophtalmology, Instituto de Oftalmologia "Conde de Valenciana", Mexico City, Mexico
  • Lucero Pedro Aguilar
    Ophtalmology, Instituto de Oftalmologia "Conde de Valenciana", Mexico City, Mexico
  • Arturo J Ramirez-Miranda
    Ophtalmology, Instituto de Oftalmologia "Conde de Valenciana", Mexico City, Mexico
  • Alejandro Navas
    Ophtalmology, Instituto de Oftalmologia "Conde de Valenciana", Mexico City, Mexico
  • Alejandro Lichtinger
    Ophtalmology, Instituto de Oftalmologia "Conde de Valenciana", Mexico City, Mexico
  • Aida Jimenez-Corona
    Ophtalmology, Instituto de Oftalmologia "Conde de Valenciana", Mexico City, Mexico
  • Enrique O Graue
    Ophtalmology, Instituto de Oftalmologia "Conde de Valenciana", Mexico City, Mexico
  • Footnotes
    Commercial Relationships Denise Loya, None; Lucero Pedro Aguilar, None; Arturo Ramirez-Miranda, Carl Zeiss Meditec (C); Alejandro Navas, Alcon Laboratories (C), Carl Zeiss Meditec (C); Alejandro Lichtinger, None; Aida Jimenez-Corona, None; Enrique Graue, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2015, Vol.56, 1552. doi:
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    • Get Citation

      Denise Loya, Lucero Pedro Aguilar, Arturo J Ramirez-Miranda, Alejandro Navas, Alejandro Lichtinger, Aida Jimenez-Corona, Enrique O Graue; OUTCOMES OF SCLERO-CORNEAL KERATOPLASTY IN SEVERE CORNEAL PERFORATIONS. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1552.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose
 

To describe visual outcomes and prognosis after sclero-corneal keratoplasty (SCK) in severely perforated eyes.

 
Methods
 

Retrospective review of clinical records of 29 patients who underwent sclero-corneal grafts for perforating lesions over a period of 13 years was performed. Information about the studied variables included demographics characteristics, medical history, surgical indications, clinical course, complications, visual outcomes and ocular integrity were analyzed. Analyses were done using Stata 13.<br /> <br /> <br /> <br /> <br />

 
Results
 

We included 25 eyes from 25 patients (12 men and 13 women), with a mean age of 50.6 ± 17.4 years. The median follow-up of the patients was 10 months. The main causes of perforation were rheumatoid corneal melt, infectious keratitis, Wegener's granulomatosis, Sjögren's syndrome, pemphigus, trauma and chemical injury. The mean preoperative best-corrected visual acuity was 2.9 ±1.3 logMAR. Postoperatively, the visual acuity only improved in 3 eyes (11.11%). The most commonly reported complications were: persistent epithelial defect in 28 %, choroidal detachment in 16%, ocular hypertension in 24%, Seidel in 16%, synechiae 16% and retinal detachment in 8%. Evisceration was required in 25% of the cases. In multiple logistic regression analysis, the main predictors associated with complications after SCK included patients pretreated with amniotic membrane transplantation or therapeutic keratoplasty (odds ratio13.8, p=0.035) and autoimmune disease background (odds ratio 10.4, p=0.06).

 
Conclusions
 

Sclero-corneal keratoplasty in autoimmune diseases and corneal perforations pretreated with amniotic membrane transplantation or therapeutic keratoplasty were associated to higher risk of complications and worse prognosis after this procedure. While sclero-corneal keratoplasty visual outcomes could be unfortunate, psychological benefits of retaining the eyeball can be obtained, as well as preserving ocular motility and avoiding enophthalmos, even in an apparently futile scenario.

 
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