[Lamellar horseshoe sclerokeratoplasty and thermoplasty in keratoconus with peripheral ectasia of the cornea].
OBJECTIVE
Peripheral ectasia of the cornea is a rare, but rather complicated form of keratoconus, which in its severest form cannot be corrected by glasses or contact lenses. Penetrating corneal grafts must be positioned directly at the limbus. Such transplants mostly fail because of a high risk of immune reactions which can only be circumvented by systemic Ciclosporin A. To avoid the potential risks of such a systemic immunomodulation we performed instead of a penetrating keratoplasty a special lamellar procedure which restored the normal configuration of the cornea.


METHODS
The 35-year-old man presented with best corrected visual acuity of 0.1 in both eyes. Contact lenses were not tolerated any longer.


RESULTS
After lamellar dissection, thermoplasty and lamellar horse-shoe sclerokeratoplasty the patient now wears well-fitting contact lenses and has a visual acuity of 0.8 with his right and 0.5 with his left eye after a follow-up period of 25 and 14 months respectively. There were no postoperative complications.


CONCLUSIONS
Lamellar horse-shoe sclerokeratoplasty preceded by lamellar corneal dissection and thermoplasty is a technically difficult, but efficient surgical measure to restore the normal corneal curvature in patients with advanced peripheral ectasia of the cornea.
Augenklinik der Heinrich-Heine-Universität Düsseldorf.
T
T
Reinhard
R
R
Sundmacher
D016039:Corneal Transplantation / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D007640:Keratoconus / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D016639:Scleroplasty / Q000379:methods*; D014792:Visual Acuity / Q000502:physiology
Lamelläre Horse-Shoe Sklerokeratoplastik und Thermoplastik bei Keratokonus mit peripherer Keratektasie.