Preop anterior segment inflammation may hinder graft transparency after keratoplasty

While keratoplasty appears helpful for maintaining ocular integrity and visual acuity, it may be difficult to achieve transparency after the first graft in patients with severe preoperative inflammation of the anterior segment, a study by researchers in Japan suggests.

Kazuomi Hanada, MD, and colleagues at Asahikawa Medical College retrospectively reviewed clinical results, including postoperative progress and complications, obtained for 20 eyes of 20 patients that underwent therapeutic keratoplasty for corneal perforation.

Corneal perforations were caused by herpetic keratitis in five eyes, bacterial ulcer in one eye, fungal ulcer in one eye, neurotrophic ulcer in three eyes, rheumatoid arthritis in two eyes, Mooren ulcer in two eyes, Terrien marginal corneal degeneration in one eye, keratoconus in one eye and Wegener granulomatosis in one eye, according to the study.

The other three corneal perforations were of unknown etiology, the authors noted.

In addition, six eyes had previously received corneal transplantation.

Sixteen eyes (80%) achieved "anatomic cures" after the first transplantation procedure, the authors reported. Visual acuity was equal to or better than baseline level in 17 eyes (85%).

In 15 eyes that underwent central penetrating keratoplasty with fresh donor tissue, the graft transparency rate was 67%, they noted.

Significant postoperative complications included cataract in six eyes, glaucoma in four eyes and recurrent disease in three eyes, according to the study, published in the February issue of Cornea.