Penetrating Keratoplasty for Pseudophakic Corneal Edema With Exchange of Intraocular Lenses

Waring, George O.; Stulting, R. Doyle; Street, Debra

doi:10.1001/archopht.1987.01060010064032

Cited by 72 publications

(6 citation statements)

References 34 publications

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“…Low visual acuity after PKP for secondary endothelial decompensation was reported by Olson [8], Busin [4], Soong [11] and Waring [14] and they observed poor visual results in spite of good graft survival, as we did. In their studies the most common problems were cystoid macular edema and glaucoma.…”

Section: Discussionmentioning

confidence: 43%

Visual results after corneal transplantation

1989

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The results of corneal transplantation can be measured by the percentage of clear grafts and by the subsequent visual acuity. In this study we summarized the visual results in five corneal diseases with a low rate of graft failure. Keratoconus patients achieved an average visual acuity of 0.5 one year after transplantation, while patients with corneal decompensation after previous cataract operation only reached an average of 0.2. Sometimes visual results were hampered by clouding of the graft and the reason for clouding was analysed in such cases. Reversible and irreversible rejections occurred with the highest frequency immediately after transplantation, and while in primary grafts 60% of rejections was reversible, only two out of ten repeat transplants could be saved. This indicates that more measures are necessary to prevent failure of secondary transplants in order to obtain the goal of useful vision.

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Section: Discussionmentioning

confidence: 43%

Visual results after corneal transplantation

1989

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“…21 Other risk factors for the development of glaucoma after PKP include pre-existing glaucoma, the presence of peripheral anterior synechiae, corneal re-grafting, a history of ocular trauma, and combined PKP and cataract extraction surgery. 19,[21][22][23]28,29 Simmons reported a fourfold increased relative risk for developing glaucoma post-keratoplasty in patients with pre-existing glaucoma vs those without a prior history of glaucoma. 30 Sihota reported a post-keratoplasty incidence of glaucoma of 10.6% in his series of 747 patients, 13% of whom underwent repeat PK for a failed corneal graft.…”

Section: Trends In Corneal Transplant Surgerymentioning

confidence: 44%

Management of patients with combined glaucoma and corneal transplant surgery

Banitt

Lee

2009

Eye

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Penetrating keratoplasty (PKP) is associated with an increased risk of secondary glaucoma. The development of glaucoma after PKP is an important risk factor for decreased corneal graft survival. The incidence of glaucoma after corneal transplant as well as the mechanism of developing increased intraocular pressure is reviewed in this paper. Treatments for post-PKP glaucoma include medications, laser, and surgery. The most frequent surgical glaucoma intervention is implantation of a glaucomadrainage device. Recent advances in corneal transplantation surgery may help to decrease corneal failure and the risk of developing post-keratoplasty glaucoma.

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“…The visual outcome is, however, limited in many cases by macular and optic nerve pathology such as cystoid macular edema, and glaucoma. A clear graft is obtained in about 90% of patients, while the incidence of cystoid macular edema (25%) and glaucoma (50%) implicate a poor visual outcome in 50% or more of patients (Soong et al 1989;Waring et d. 1987;Zaidman & Goldman 1990;Insler et al 1989;Koenig & Schultz 1988). Penetrating keratoplasty in complicated cases of pseudophakic bullous keratopathy might necessitate a c u l t and major reconstruction of the anterior ocular segment, iridoplasty and gonioplasty (Waring 1987).…”

Section: Discussionsupporting

confidence: 40%

Intentional retention of Descemet's membrane in keratoplasty for the surgical treatment of bullous keratopathy

Loewenstein

Geyer

Lazar

1993

Acta Ophthalmologica

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We report on a modified keratoplasty procedure performed in 6 patients for the treatment of severe pseudophakic bullous keratopathy. While removing the host's cornea, the Descemet membrane was retained, and a full thickness graft sutured on top of it. Postoperatively, aqueous separated the host's Descemet membrane from the graft, thus forming a supernumerary anterior chamber. The graft remained clear in 5 of these patients during up to 28 months of follow-up. We suggest that in some severely damaged and high risk eyes, where opening the anterior chamber might be associated with difficulties and complications, it could be worthwhile to perform an 'extraocular' procedure by retaining the host's Descemet membrane.

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Penetrating Keratoplasty for Pseudophakic Corneal Edema With Exchange of Intraocular Lenses

Cited by 72 publications

References 34 publications

Visual results after corneal transplantation

Visual results after corneal transplantation

Management of patients with combined glaucoma and corneal transplant surgery

Intentional retention of Descemet's membrane in keratoplasty for the surgical treatment of bullous keratopathy

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