Contralateral Autologous Corneal Transplantation Experience in Mexico City

Pérez-Balbuena, Ana Lilia; Ancona‐Lezama, David; Delgado-Pelayo, Sarai; Martínez, J.

doi:10.1097/ico.0000000000001020

Cited by 9 publications

(5 citation statements)

References 13 publications

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“…Therefore, we decided to proceed with a contralateral autologous PK as tissue isogeneity would be associated with a lower the risk of rejection compared to an allograft [3]. Up to this date, 103 cases of contralateral APK have been reported in the literature with an overall success rate of 77.4% at a mean follow-up time of 54 months [3,4,[13][14][15]. The results of the APK case reports published in the last 10 years are summarized in Table 1.…”

Section: Discussionmentioning

confidence: 99%

“…To this date, two cases of expulsive hemorrhage have been described as a complication of contralateral APK in the blind recipient eye. In these cases, the authors used either a temporary keratoprosthesis or an oversized glycerin-preserved cornea on the recipient site to provide tectonic support [ 4 , 13 ]. Along with other proposed measures, such as preoperative mannitol infusion and control of the intraocular and systemic blood pressure, simultaneous surgery could provide another alternative in controlling the risk of this dreadful complication in APK cases.…”

Section: Discussionmentioning

confidence: 99%

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Semi-Autologous Corneal Transplantation with Simultaneous Bilateral Surgery: A Case Report

Kounatidou,

Kopsini,

Gibbons

et al. 2023

Case Rep Ophthalmol

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The present report describes a case of semi-autologous corneal transplantation with bilateral surgery using two operating microscopes simultaneously. An 86-year-old man with history of six prior failed penetrating keratoplasties in his right eye presented with decreased vision. His other eye was deeply amblyopic but had a clear 30-year-old Castroviejo-square graft with an endothelial cell count of 803 cells/mm2. A semi-autologous graft was performed from the left eye to the right. Surgery was performed simultaneously on both eyes by two different surgeons using a standard ophthalmic operating microscope as well as a second ENT microscope. Upon trephination of the right failed corneal graft, vitreous opacities were noted and sent for culture. The semi-autologous tissue was directly transferred from the left eye to the right without any storage in preservation media to avoid endothelial cell loss. The semi-autologous graft remained clear in the immediate postoperative period. However, the vitreous cultures grew coagulase-negative Staphylococcus. Despite all efforts, the patient eventually developed a retinal detachment and vision in the right eye decreased to light perception. Autologous penetrating keratoplasty is an option for patients with loss of corneal function in a potentially seeing eye and a clear cornea in a contralateral eye with poor visual potential due to non-corneal disease. This case is unique in that part of the autologous penetrating keratoplasty had an old square graft in the center and corneal transplant surgery was done simultaneously in both eyes. It also highlights chronic indolent endophthalmitis as a potential cause of multiple graft failures.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Semi-Autologous Corneal Transplantation with Simultaneous Bilateral Surgery: A Case Report

Kounatidou,

Kopsini,

Gibbons

et al. 2023

Case Rep Ophthalmol

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“…Autokeratoplasty can be ipsilateral rotational, for a paracentral corneal scar, 8 or contralateral, when the patient has an opaque cornea in an otherwise healthy eye, and a transparent cornea in a fellow blind eye. 1 3 Sanjuán et al . reported the largest case series of contralateral autokeratoplasty, with 31 eyes.…”

Section: Discussionmentioning

confidence: 99%

“…Frequent complications such as steroid-induced glaucoma and graft rejection would be avoided with this procedure, 1 2 and it might be useful in developing countries as well where donor tissue could be scarce. 3 When combined with pars plana vitrectomy (PPV) for mixed anterior and posterior segment disease, a temporary keratoprosthesis might be needed. 4 5 In complex cases with cataract, aphakia, or a severely damaged anterior segment, placing an intraocular lens (IOL) in the capsular bag or the ciliary sulcus might not be feasible.…”

Section: Introductionmentioning

confidence: 99%

Contralateral Autokeratoplasty, Pars Plana Vitrectomy for Luxated Cataract, and Flanged Intrascleral Intraocular Lens Fixation

Saá

Cremona

Cotic

et al. 2022

Journal of Current Ophthalmology

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Purpose: To describe a case of a combined procedure including autokeratoplasty, pars plana vitrectomy (PPV), and scleral intraocular lens (IOL) fixation. Methods: Case report. Results: We describe a case of an 85-year-old patient presenting a right, blind eye with a clear cornea and a left eye with acceptable visual potential but affected by bullous keratopathy, aphakia, and a posteriorly dislocated nucleus. The patient underwent a contralateral autokeratoplasty, PPV, and flanged intrascleral IOL fixation with double needle technique. After 24 months of follow-up, the graft remained clear, and the IOL was stable. Conclusions: Complex cases comprising anterior and posterior segments pathology sometimes require combined procedures. A shortage of corneal tissue in developing countries is common. In strictly selected cases, autokeratoplasty may be an option and is associated with fewer complications than allograft corneal transplantation. Sutureless novel techniques for intrascleral fixation of IOL have shown good results and reliable lens stability.

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“…Autologous contralateral autograft has been described as a useful procedure in patients who require which suggest that autokeratoplasty have higher chances of graft survival due to the absence of immune graft rejection with resultant postoperative endothelial cell loss which is the major cause of graft failure in the long term [5,6].…”

Section: Introductionmentioning

confidence: 99%

Simultaneous Corneal Allograft and Contralateral Corneal Autograft: A Case Report

Sitaula¹,

Sanjay²

2019

Int J Ophthalmol Clin Res

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Introduction: Autologous contralateral autograft has been described as a useful procedure in patients who require penetrating keratoplasty on their only functional eye and have a clear cornea on their nonfunctional eye due to the low chances of graft rejection in autografts. Here we describe a case where we were able to salvage vision by corneal autografting in a blind patient. Case: A 65-year-old male had blurred vision in both eyes with visual acuity of perception of light (PL) in right eye (RE) and hand motion (HM) in left eye (LE). On examination, RE had a clear cornea, sluggish pupillary reaction with presence of Relative afferent pupillary defect and glaucomatous optic atrophy. Left eye had a corneal opacity following healed corneal ulcer. RE Penetrating Keratoplasty (PK) using an allograft and left eye PK using the contralateral autograft was done. Post-operatively, RE developed persistent epithelial defect and eventually failed after 2 months while the left autograft got fully epithelialized and remained clear till 2 years follow up even after steroids were stopped. Conclusion: Autokeratoplasty have higher chances of graft survival due to the absence of immune graft rejection and resultant postoperative endothelial cell loss. Hence, it may be considered first in any case where there is this unique combination of opaque cornea in an eye with better visual potential and a clear cornea in an eye without visual potential.

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Contralateral Autologous Corneal Transplantation Experience in Mexico City

Cited by 9 publications

References 13 publications

Semi-Autologous Corneal Transplantation with Simultaneous Bilateral Surgery: A Case Report

Semi-Autologous Corneal Transplantation with Simultaneous Bilateral Surgery: A Case Report

Contralateral Autokeratoplasty, Pars Plana Vitrectomy for Luxated Cataract, and Flanged Intrascleral Intraocular Lens Fixation

Simultaneous Corneal Allograft and Contralateral Corneal Autograft: A Case Report

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