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Related Experiment Videos

Tectonic keratoplasty for peripheral ulcerative keratitis.

M B Raizman1, M Sainz de la Maza, C S Foster

  • 1Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston 02114.

Cornea
|July 1, 1991
PubMed
Summary

Tectonic keratoplasty combined with immunosuppression effectively preserves eyes with severe peripheral ulcerative keratitis (PUK). This approach helps prevent corneal perforation and maintain vision in challenging cases of inflammatory eye disease.

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Area of Science:

  • Ophthalmology
  • Corneal Surgery
  • Inflammatory Eye Diseases

Background:

  • Peripheral ulcerative keratitis (PUK) is a severe inflammatory condition that can lead to corneal perforation and vision loss.
  • Standard treatments include conjunctival resection, cyanoacrylate adhesive, and immunosuppression.
  • Impending or actual corneal perforation necessitates advanced surgical interventions like lamellar or penetrating keratoplasty.

Observation:

  • This study reports on 17 eyes from 14 patients with PUK who underwent tectonic keratoplasty due to progressive ulceration.
  • The surgical intervention aimed to maintain the structural integrity of the globe in eyes with severe corneal compromise.

Findings:

  • The combination of tectonic keratoplasty and systemic immunosuppression successfully preserved the globe in 15 out of 17 eyes.

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  • Visual acuity was maintained or improved in 8 eyes post-surgery.
  • Six eyes achieved a final visual acuity of 20/200 or better, indicating significant visual recovery.

    • Implications:

    • Tectonic keratoplasty with immunosuppression is a viable therapeutic strategy for managing sight-threatening PUK.
    • This approach can prevent globe loss in cases unresponsive to less invasive treatments.
    • The findings support the use of aggressive surgical management in conjunction with medical therapy for severe ulcerative keratitis.