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[Keratoplasty à chaud]

N Stübiger1, U Pleyer, C Erb

  • 1Universitäts-Augenklinik Tübingen.

Der Ophthalmologe : Zeitschrift Der Deutschen Ophthalmologischen Gesellschaft
|August 1, 1995
PubMed
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Keratoplasty à chaud effectively preserves severely threatened eyes with bacterial or herpetic keratitis. While visual acuity improves, complications like allograft rejection and cataracts necessitate further interventions for full visual rehabilitation.

Area of Science:

  • Ophthalmology
  • Corneal Surgery
  • Infectious Eye Diseases

Context:

  • Progressive bacterial and herpetic keratitis pose significant threats to vision.
  • Urgent surgical intervention is often required for corneal perforation and descemetocele.
  • Keratoplasty à chaud (emergency corneal transplantation) was evaluated for these severe cases.

Purpose:

  • To assess the efficacy and outcomes of keratoplasty à chaud in eyes with progressive bacterial and herpetic keratitis.
  • To analyze graft survival rates, visual acuity improvements, and complication profiles.
  • To determine the long-term functional results and need for secondary procedures.

Summary:

  • 128 keratoplasties à chaud were performed on eyes with severe bacterial (69) or herpetic (59) keratitis, including cases with perforation or descemetocele.

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  • Graft survival was high (95%), with improved visual acuity in 54% of bacterial and 69% of herpetic cases.
  • Major complications included allograft rejection (71% bacterial, 63% herpetic), cataracts (61% bacterial, 44% herpetic), and herpes recurrence (23% herpetic).

    • Impact:

    • Keratoplasty à chaud is a valuable emergency procedure for managing severe keratitis, preserving threatened eyes, and improving initial visual function.
    • Despite initial success, a significant proportion of patients require secondary re-keratoplasty and cataract surgery for complete visual rehabilitation.
    • The study highlights the balance between urgent sight-saving intervention and the long-term management of complications in corneal transplantation for infectious keratitis.