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Ocular surface deficits contributing to persistent epithelial defect after penetrating keratoplasty
Yao Fu1, Jingbo Liu, Scheffer C G Tseng
1Department of Ophthalmology, Ninth People's Hospital, Medical School of Shanghai Jiaotong University, Shanghai, China.
Cornea
|April 13, 2012
Summary
Persistent epithelial defects (PED) after penetrating keratoplasty (PKP) are often caused by multiple ocular surface issues like infrequent blinking and lagophthalmos. Addressing these deficits with corrective measures improves graft survival in severe ocular surface diseases.
Area of Science:
- Ophthalmology
- Corneal Surgery
- Ocular Surface Disease
Background:
- Persistent epithelial defect (PED) is a significant complication following penetrating keratoplasty (PKP).
- Understanding the specific ocular surface deficits contributing to PED is crucial for improving graft outcomes.
Purpose of the Study:
- To identify and characterize the ocular surface deficits that lead to persistent epithelial defects (PED) after penetrating keratoplasty (PKP).
Main Methods:
- A review of 11 eyes with PED post-PKP was conducted, focusing on four key ocular surface deficits and their management.
- Patients underwent corrective measures including bandage contact lenses, tarsorrhaphy, and fornix reconstruction.
Main Results:
- All 11 patients had multiple ocular surface deficits, with infrequent blinking and lagophthalmos being most prevalent.
- Corrective measures led to epithelialization within 1-3 weeks in most cases.
- Graft survival was observed in 8 eyes, while 3 eyes experienced recurrent PED and graft failure, with two requiring repeat PKP and oral mucosal grafts.
Conclusions:
- Beyond neurotrophic states and dry eye, infrequent blinking, lagophthalmos, and pathogenic symblepharon are significant contributors to PED after PKP.
- Effective management of these deficits and diligent follow-up are essential for long-term PKP graft survival in patients with severe ocular surface disease.
