Abstract
Purpose: :
To quantify the donor graft behavior by anterior elevation (AE) in patients with keratoconus after penetrating keratoplasty (PKP).
Methods: :
Cases report from March to October 2005. We included patients with keratoconus ( Krumeich classification ), who PKP were performed. PKP technique was done with 16 separate stitches, done by only one surgeon. None of stitches were removed. Trephines ranged from 7.5 to 8.5 in donor and recipient. Keratoconus base was included into the trephination. Preoperative (Preop) and postoperative (Postop) at 1, 2, 3 month, topographic astigmatism (TA) and AE (Orbscan II) inside the 3 mm optical zone were measured. Maps were standardized with predetermined best fit sphere (BFS). Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), refractive error, spherical equivalent (SE) were studied and correlated with the AE behavior preop and postop.
Results: :
3 patients were included, 1 male and 2 females, mean age 25 years old. Case 1: BFS was 6.27mm/53.9D. Preop AE was +109 µ, and – 345µ, – 386µ , –417µ at 1, 2,3 month postop respectively. UCVA was 20/400 preop and 20/400 1 month, 20/200 2 month, and 20/200 3 month. BCVA was 20/300 preop, and 20/60 at the 3 month. SE was – 6.00 D preop and + 9.75 D at the 3 month. TA was – 9.00 x 180° preop and –1.20 x 96° postop. Case 2:BFS was 6.14mm/55.0D Preop AE was +47µ, –550µ, –256µ, –485 µ at 1,2,3 month postop respectively. UCVA was CF preop and CF 1 month, CF 2 month, 20/400 3 month. BCVA was 20/400 preop, and 20/60 at the 3 month. SE was –12.50 D preop and +10.00 D at the 3 month. TA was –4.20 x 22° preop and –14.3 x 40° postop. Case 3:BFS was 6.47mm/52.1D Preop AE was +155µ, –494µ, –398µ, –405µ at 1,2,3 month postop respectively. UCVA was CF preop and 20/300 1 month, 20/200 2 month, 20/100 3 month. BCVA was 20/200 preop and 20/60 at the 3 month. SE –19.50 D preop and –1.00 D at the 3 month. TA –6.70 x 90° preop and –2.6 x 148 ° postop.
Conclusions: :
There is a quantified movement of donor cornea during the first 3 months of follow up. No correlation between this one and UCVA, refractive error and TA was seen.
Keywords: topography • keratoconus • keratoconus