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Keratoplasty for pseudophakic keratopathy.
Australian and New Zealand Journal of Ophthalmology
|November 1, 1985
Summary
Corneal grafts for lens-induced keratopathy showed good clarity, but visual outcomes were limited by glaucoma and maculopathy. Long-term follow-up is crucial for maintaining graft clarity after these complex surgeries.
Area of Science:
- Ophthalmology
- Corneal Surgery
- Intraocular Lens Complications
Background:
- Lens-induced keratopathy is a sight-threatening complication following intraocular lens (IOL) implantation.
- Penetrating keratoplasty is a potential surgical option for managing severe corneal dysfunction secondary to IOLs.
Purpose of the Study:
- To evaluate the outcomes of penetrating corneal grafts in eyes with keratopathy caused by various types of intraocular lenses.
- To assess the graft clarity and visual results following surgical intervention.
Main Methods:
- Penetrating corneal grafts were performed on 17 eyes with keratopathy attributed to iris-supported, anterior chamber, or posterior chamber IOLs.
- A meticulous surgical technique involving a softened eye, Flieringa ring, anterior vitrectomy, and sodium hyaluronate was employed.
- Efforts were made to retain or reposition existing IOLs.
Main Results:
- Clear corneal grafts were achieved in 13 out of 17 eyes (76.5%).
- Despite good graft clarity, visual acuity was often poor, primarily due to coexisting glaucoma and/or maculopathy.
- Some IOLs were successfully repositioned and sutured to the iris.
Conclusions:
- Penetrating keratoplasty can achieve satisfactory graft clarity in eyes with IOL-induced keratopathy.
- Visual outcomes are frequently compromised by secondary ocular pathologies like glaucoma and maculopathy.
- Long-term postoperative management, including topical corticosteroids and timolol, is essential for sustained graft clarity and visual function.