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N. Vandemeulebroecke, H. Spelsberg; Homologous Penetrating Central Limbokeratoplasty versus Conventional Homologous Penetrating Keratoplasty and Hard Contact Lens in Granular and Lattice Corneal Dystrophy. Invest. Ophthalmol. Vis. Sci. 2008;49(13):2334.
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After conventional penetrating keratoplasty, recurrences are frequently observed in granular and lattice corneal dystrophy. Homologous penetrating central limbokeratoplasty was introduced to avoid recurrences, but did not fullfill the expectations. Soft contact lenses are reported to have a positive effect to maintain a clear graft after keratoplasty (Roters et al., 2004). The aim of this prospective study is to investigate whether recurrences of the dystrophy can be avoided by fitting a hard contact lens after removal of all sutures in conventional penetrating keratoplasty. These results are compared with the experiences with limbokeratoplasty.
In 41 eyes with granular or lattice dystrophy limbokeratoplasty was performed between 1995 and 2003. Since 2003 twenty-seven eyes with lattice or granular dystrophy underwent conventional penetrating keratoplasty. Seven of them were treated with a fitted hard contact lens after removal of all sutures 18 months postoperatively.
14 recurrences were observed in 41 eyes after limbokeratoplasty with a mean follow-up time of 1684 days (range 34 - 3940 days, median: 1547 days). 2 recurrences occured in 25 eyes after penetrating or lamellar keratoplasty with a mean follow-up time of 678 days (range 4 - 1682 days, median: 537 days). One of the 10 eyes with a fitted contact lens after conventional keratoplasty, presented signs of recurrence, The mean follow up time of these 10 eyes were 927 days (range 272 -1682 days, median: 940 days).
Considering only one recurrence, wearing a hard contact lens after penetrating keratoplasty seems to avoid or minimize recurrences of a granular or lattice dystrophy. Despite the short follow-up time these results are encouraging to find good fitting solutions in more patients after conventional keratoplasty. Further observations willbe presented in the future.
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