Purpose:
Our aim is to report about the outcome of corneal transplantation in aphakic eyes.
Methods:
We examined 17 eyes of 17 patients. Diagnosis in 11 eyes was corneal endothelial decompensation and in 6 extensive corneal scars. Aphakia followed a penetrating corneal trauma in 10 eyes, an intracapsular cataract extraction in 6 and removal of anterior chamber intraocular lens in one eye. Three of these eyes had undergone a pars plana vitrectomy. We performed an excimer laser penetrating keratoplasty with intraoperative stabilization by "Flieringa ring" in all of the eyes. Follow-up ranged between 3 and 41 (17.6 ± 11.7) months. Main outcome measures included: best corrected visual acuity (BCVA), intraocular pressure (IOP), topographic astigmatism, corneal refractive power (CRP), central corneal thickness (CCT) and endothelial cell density (ECD).
Results:
Preoperative BCVA was light perception in 2 eyes, hand motion in 7, finger counting in one eye, under 20/400 in 6 eyes and 20/200 in one eye. IOP ranged between 4 and 28 (13.6 ± 5.1) mmHg. Astigmatism ranged from 0.5 to 18.5 (7.0 ± 6.9) dioptres. CRP was between 38 and 59 (46 ± 9) diopters. CCT was between 404 and 1069 (748 ± 181) µm. Postoperative BCVA was hand motion in 5 eyes, under 20/400 in 2 and ranged between 20/200 and 20/20 in 10 eyes. IOP ranged between 10 and 40 (18.3 ± 8.5) mmHg. Astigmatism ranged from 0.9 to 13 (5.5 ± 3.2) dioptres. CRP was between 31.9 and 46.7 (42 ± 4.1) diopters. CCT was between 349 and 820 (552 ± 115) µm. ECD was between 592 and 2319 (1674 ± 553) cells/mm².
Conclusions:
Intraoperative stabilisation by "Flieringa ring" is necessary during corneal grafting in aphakic eyes, especially if they have been previously vitrectomized. Given adequate preoperative IOP regulation and postoperative follow-up, most of the patients achieve subjectively beneficial visual outcomes.
Keywords: transplantation • cornea: clinical science