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The Castroviejo square graft: a retrospective study
J V Aquavella1, R S Smith, J J Ruffini
1Cornea Research Laboratory, University of Rochester Medical Center, New York.
Refractive & Corneal Surgery
|July 1, 1989
Summary
The Castroviejo square graft technique for penetrating keratoplasty showed a 42% failure rate, often due to irreversible corneal edema. Some clear grafts required contact lens correction for optimal vision.
Area of Science:
- Ophthalmology
- Corneal Surgery
- Microscopy
Background:
- Penetrating keratoplasty is a common corneal transplant procedure.
- The Castroviejo square graft technique is one method used for corneal transplantation.
Purpose of the Study:
- To evaluate the long-term outcomes of the Castroviejo square graft technique in penetrating keratoplasty.
- To investigate the structural integrity and potential failure mechanisms of square corneal grafts.
Main Methods:
- Retrospective analysis of 19 eyes from 12 patients who underwent penetrating keratoplasty using the Castroviejo square graft technique.
- Assessment of visual acuity and graft clarity.
- Light and electron microscopy of eight failed grafts to examine graft-host junctions and Descemet's membrane.
Main Results:
- Nine out of 19 (47%) square grafts were functionally clear, with six requiring contact lens correction.
- Eight grafts (42%) failed, primarily due to irreversible corneal edema.
- Microscopic examination revealed continuous stromal lamellae at the graft-host junction but disruptions and compositional differences in Descemet's membrane.
Conclusions:
- The Castroviejo square graft technique has a significant failure rate, with corneal edema being a major complication.
- Structural integrity of the graft-host junction is generally maintained, but Descemet's membrane abnormalities may contribute to graft failure.
- Further research is needed to optimize graft survival and reduce complications in corneal transplantation.