Therapeutic Effects of Lamellar Keratoplasty on Terrien Marginal Degeneration

To evaluate the therapeutic effects of lamellar keratoplasty (LK) on Terrien marginal degeneration (TMD).

Retrospective interventional case series. Medical records of 63 patients (71 eyes) who received LK for TMD at Qingdao Eye Hospital, Shandong Eye Institute from December 1995 to March 2014 were reviewed. A total of 56 eyes were treated with partial LK and 15 eyes with total LK. Complications, visual acuity recovery, and graft status were evaluated.

Mean age of the patients was 50.4 ± 16.8 years. The follow-up period was 2.5 ± 0.9 years. The uncorrected distance visual acuity (UDVA) increased from preoperative 0.90 ± 0.44 logarithm of the minimum angle of resolution (logMAR) to 0.53 ± 0.27 logMAR at 1 year after surgery (t = 16.256, P < 0.001). The corrected distance visual acuity (CDVA) was 0.69 ± 0.30 logMAR preoperatively, and increased to postoperative 0.38 ± 0.22 logMAR (t = -19.982, P < 0.001). After surgery, mean astigmatism was 5.33 ± 2.44 diopters (D) compared with preoperative 10.19 ± 4.32 D (t = 7.351, P < 0.001), and the spherical equivalent decreased from preoperative -2.23 ± 2.34 D to -0.75 ± 2.04 D (t = -2.677, P = 0.012). There was a significant difference in UDVA, ΔUDVA, CDVA, ΔCDVA, and refractive astigmatism between the partial LK and total LK groups. The most common intraoperative complication was corneal perforation. The postoperative complications included double anterior chamber, persistent graft epithelium defects, corneal vascularization, immune rejection, graft ulcers, cataract, and recurrence of marginal degeneration.

LK can effectively reduce refractive errors, improve visual acuity, and reduce the risk of corneal perforation for patients with TMD. The visual acuity after partial LK is superior to that after total LK.