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Limbal stem cell-sparing lamellar keratoplasty for the management of advanced keratoglobus
Farid Karimian1, Alireza Baradaran-Rafii, Amir Faramarzi
1*Cornea and External Disease Service, Department of Ophthalmology, Shahid Beheshti University of Medical Sciences, Tehran, Iran; and †Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Purpose:
To describe the technique and outcomes of limbal stem cell-sparing lamellar keratoplasty (LSCS-LKP) for the management of advanced keratoglobus (KGB).
Methods:
In a sequential interventional case series from March 2010 to December 2012, 8 eyes of 6 patients with advanced KGB underwent an LSCS-LKP. Three patients had isolated KGB, 2 were affected with the Ehlers-Danlos syndrome, and the other subject had osteogenesis imperfecta. Epithelial healing, anatomical results (corneal thickness and keratometry), and visual outcomes were evaluated after this intervention.
Results:
Three of the 6 patients were male. Complete epithelial healing occurred in 7 eyes during 2 weeks. Refractory persistent epithelial defect and graft melting occurred in 1 eye. Corneal thickness increased and central keratometry decreased after the LSCS-LKP was performed in all the patients. The patients were followed up for at least 6 months. Visual acuity improved in all eyes except 1.
Conclusions:
LSCS-LKP is an effective procedure for preserving ocular integrity and for improving visual acuity in patients with advanced KGB. Early surgical intervention can be considered before the occurrence of vision-threatening traumatic corneal rupture.
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