Postkeratoplasty Corneal Plaques: A Case Series

Area of Science:

• Ophthalmology
• Corneal Surgery
• Ocular Pathology

Background:

• Corneal plaques are a potential complication following keratoplasty.
• Persistent epithelial defects can precede plaque formation.
• Understanding risk factors and management is crucial for graft survival.

Purpose of the Study:

• To assess risk factors associated with corneal plaque formation after keratoplasty.
• To evaluate management strategies for post-keratoplasty corneal plaques.
• To determine the chemical composition of these plaques.

Main Methods:

• Retrospective review of medical records for eyes with corneal plaques post-keratoplasty (January 2014 - January 2022).
• Data collection included pre-keratoplasty pathology, ocular risk factors, surgical details, complications, and plaque management.
• Chemical composition analyzed using infrared spectrometry.

Main Results:

• Thirteen eyes were analyzed, with ocular surface disorders (including dry eye) being common predisposing factors.
• Surgical excision and amniotic membrane transplantation (AMT) were performed in 12 eyes; 5 experienced recurrence.
• Plaques were composed of ammonium magnesium phosphate/calcium phosphate carbonate (75%) or mucus (25%).

Conclusions:

• Post-keratoplasty corneal plaque formation is an underestimated complication.
• Ocular surface disorders are primary risk factors.
• Medical treatment or scraping has a guarded prognosis; regrafting may be essential for graft clarity.