Penetrating Keratoplasty after Radial Keratotomy

Extracellular Matrix Changes in Human Corneas After Radial Keratotomy

“…Refractive surgery has been used over several decades to correct mild to moderate myopia, hyperopia, presbyopia and astigmatism (Binder, 1994 ;Parmley et al, 1995). A common refractive surgical procedure, radial keratotomy (RK), has shown success in correcting these visual defects (Waring et al, 1991 ;Jester et al, 1992).…”

“…RK usually consists of performing 4 to 8 radial incisions on the cornea [sometimes, 2 incisions (Suarez et al, 1997)] at close to maximum depth with a resultant central corneal flattening. Infrequently, RK may result in over-and undercorrection, glare, fluctuation of vision, epithelial erosion, map-dot-fingerprint epithelial dystrophy, epithelial edema, ectasia and delayed bacterial keratitis (Nelson et al, 1985 ;Jester et al, 1992 ;Wellish et al, 1994 ;Parmley et al, 1995 ;Venter, 1997). These complications may be due to a delayed and incomplete wound healing, although molecular mechanisms of their development are not fully understood (Binder et al, 1987 ;Glasgow et al, 1988 ;Jester et al, 1992 ;Assil and Quantock, 1993 ;Binder, 1994 ;Melles, Binder and Anderson, 1994).…”

Descemet membrane endothelial keratoplasty for endothelial decompensation after previous radial keratotomy

“…There have been several case reports regarding surgical management of corneal decompensation after RK 8, 9, 10, 11. Kubaloglu et al reviewed 24 eyes which underwent PK after RK for keratoconus and found post-operative BCVA to average 20/32, with a graft rejection rate of 25% (6 eyes) 8 .…”

“…Several complications of RK have been described in the literature, including corneal perforation, 1 decentration, 2 over- or undercorrection, 1 irregular astigmatism, contact lens intolerance, 2 stromal melting, infection, 3 and endothelial cell loss 4, 5, 6. There have been case reports of corneal transplantation performed for intolerable side effects from prior radial keratotomy, including penetrating keratoplasty (PKP)7, 8, 9 and Descemet stripping automated endothelial keratoplasty (DSAEK) 10 , 11 after RK. There is one report 12 in the literature on managing patients with Fuchs’ endothelial corneal dystrophy with loss of vision after radial keratotomy using either penetrating keratoplasty or DSAEK.…”

Non-Descemet stripping automated endothelial keratoplasty for post radial keratotomy corneal edema

“…Intraoperative dehiscence of RK wound during penetrating keratoplasty (PK)[ 5 ] as well as in clear corneal incision phacoemulsification[ 6 ] has been reported. We preferred EK over PK in our patient because of his monocular status, and we wanted to avoid the potential globe-threatening complications associated with PK.…”