June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
Outcome of Combined Penetrating Keratoplasty and Vitreoretinal Surgery using Temporary Eckardt Keratoprosthesis and Analysis for Factors affecting Corneal Allograft Survival
Author Affiliations & Notes
  • Dae Seung Lee
    Ophthalmology, Seoul National University, Seoul, Republic of Korea
  • Jang won Heo
    Ophthalmology, Seoul National University, Seoul, Republic of Korea
  • Mee Kum Kim
    Ophthalmology, Seoul National University, Seoul, Republic of Korea
  • Hyuk Jin Choi
    Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Republic of Korea
  • Won Ryang Wee
    Ophthalmology, Seoul National University, Seoul, Republic of Korea
  • Joo Youn Oh
    Ophthalmology, Seoul National University, Seoul, Republic of Korea
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 3073. doi:
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      Dae Seung Lee, Jang won Heo, Mee Kum Kim, Hyuk Jin Choi, Won Ryang Wee, Joo Youn Oh; Outcome of Combined Penetrating Keratoplasty and Vitreoretinal Surgery using Temporary Eckardt Keratoprosthesis and Analysis for Factors affecting Corneal Allograft Survival. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3073.

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Abstract
 
Purpose
 

To evaluate the outcome of combined penetrating keratoplasty and vitreoretinal surgery using temporary Eckardt keratoprosthesis and to analyze the factors affecting the corneal allograft survival.

 
Methods
 

We reviewed medical records of 11 patients who underwent combined corneal allotransplantation and pars plana vitrectomy using temporary Eckardt keratoprosthesis. Primary outcome measure was the survival rate of corneal grafts. Patient demographics, clinical features of the cornea and retina such as disease entities and preoperative status, or surgical methods were compared between the group with graft rejection and the group with graft survival.

 
Results
 

The overall graft survival rate was 45.5 % (5/11 eyes). Retinal surgery was successful in 90.9 % (10/11 eyes). Rejection occurred in 5 patients (45.5 %, 5/11 eyes) with the mean survival time of 82.8 days during a follow up of 579 days. Four of 5 cases had the graft rejection within 2 months after surgery, and one patient had rejection at 7 months. The presence of inflammation or vascularization in the cornea before surgery was a significant factor affecting the occurrence of graft rejection (p value = 0.006). Active inflammation was present preoperatively in the recipient cornea in all patients with rejection. Corneal neovascularization was present in the recipient cornea in 4 of 5 patients with rejection. In contrast, there was no inflammation or vascularization in patients without rejection. The patient age, the presence of glaucoma, entities of corneal and retinal diseases, types of retinal surgery including the use of silicone oil or gas tamponade had no significant correlation with the graft survival or rejection.

 
Conclusions
 

Combined corneal allotransplantation and pars plana vitrectomy using temporary Eckardt keratoprosthesis allowed for successful surgical intervention of retinal diseases in patients with coexisting corneal opacity. Although the retinal outcome was excellent in 90.9 %, corneal allografts survived in 45.5%, largely depending on the preoperative status of the cornea including the presence of active inflammation or vascularization.

 
Keywords: 479 cornea: clinical science • 762 vitreoretinal surgery • 741 transplantation  
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