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Oversized corneal grafts for corneal opacities with iridocorneal adhesions
1Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
Objective:
To evaluate the efficacy of 1-mm oversized corneal grafts in patients with acquired corneal opacities and extensive peripheral iridocorneal adhesions.
Design:
Prospective noncomparative case series.
Participants:
Twenty patients (20 eyes) aged 15 years or older with unilateral or bilateral corneal opacification and a shallow anterior chamber.
Intervention:
Penetrating keratoplasty was performed with donor corneal buttons oversized by 1 mm.
Main Outcome Measures:
The various parameters evaluated were visual acuity, graft clarity, keratometry, anterior chamber depth, intraocular pressure, and spherical equivalent refraction 12 months after surgery.
Results:
The keratoplasties were performed in 15 eyes with a corneo-iridic scar after infectious keratitis (75%) and 5 eyes with failed graft (25%). At the final follow-up, a clear graft was achieved in 17 eyes (85%), and 14 eyes (70%) achieved a best-corrected visual acuity of 6/12 or better. Three of the grafts failed because of rejection. The average keratometry was 44.1 +/- 1.0 diopters (D), and the mean spherical equivalent was -3.23 +/- 2.86 D. The oversized grafts provided a mean anterior chamber depth of 2.36 +/- 0.42 mm, and the mean intraocular pressure at the 12 month follow-up was 16.38 +/- 2.09 mmHg.
Conclusions:
Corneal grafts oversized by 1 mm provide adequate anterior chamber depth and reduce the risk of peripheral anterior synechiae and secondary glaucoma in patients with corneal opacities and extensive peripheral iridocorneal adhesions.