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Emanuela Filomena Legrottaglie, Luigi Mosca, Laura Guccione, Luca Mosca, Monica Riso, Alessandra Casucci, Maria Antonietta Blasi, Emilio Balestrazzi; Unusual Surgical Application Of Corneal Graft After Removal Of Anterior Ocular Neoformations. Invest. Ophthalmol. Vis. Sci. 2011;52(14):364.
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To evaluate the safety and the effectiveness of tectonic penetrating keratoplasty in surgical removal of anterior ocular neoformations (melanomas of iris and ciliary body, epithelial cysts of anterior chamber (AC), corneal carcinomas).
Five patients (1M, 4F; mean age: 56.8 yrs +/- 7.8SD) with different anterior ocular neoformations (1 epithelial cysts of AC, 2 cilio-choroidal melanomas, 1 recurrent basal cell carcinoma of the conjunctiva, and 1 recurrent cilio-choroidal melanoma) were submitted to surgical complete excision of the neoformation and to eyeball reconstruction with a corneal graft. All eyes were submitted to complete slit-lamp evaluation, UCVA and BSCVA, ocular ultrasound examination, ocular fundus examination, preoperatively and at each visit during the follow-up (mean: 15.6 mos +/-6.8 SD; range: 6 to 26 months).
During the follow-up, 4 of 5 eyes resulted healthy, and in the one left, a recurrence of the basal cell carcinoma, six months after surgery, made compulsory an evisceration of the eye. In one case a new penetrating keratoplasty was performed to refractive purpose to restore vision.
In our experience, in case of anterior segment neoformation excision we used different tissues such as human sclera, bovine pericardium, human amniotic membrane, without lasting results. As an alternative, corneal graft seems to allow long-lasting anatomical reconstruction of eyeball integrity due to the strength and integration with surrounding tissues.
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