Oversized corneal grafts for corneal opacities with iridocorneal adhesions.
OBJECTIVE
To evaluate the efficacy of 1-mm oversized corneal grafts in patients with acquired corneal opacities and extensive peripheral iridocorneal adhesions.


METHODS
Prospective noncomparative case series.


METHODS
Twenty patients (20 eyes) aged 15 years or older with unilateral or bilateral corneal opacification and a shallow anterior chamber.


METHODS
Penetrating keratoplasty was performed with donor corneal buttons oversized by 1 mm.


METHODS
The various parameters evaluated were visual acuity, graft clarity, keratometry, anterior chamber depth, intraocular pressure, and spherical equivalent refraction 12 months after surgery.


RESULTS
The keratoplasties were performed in 15 eyes with a corneo-iridic scar after infectious keratitis (75%) and 5 eyes with failed graft (25%). At the final follow-up, a clear graft was achieved in 17 eyes (85%), and 14 eyes (70%) achieved a best-corrected visual acuity of 6/12 or better. Three of the grafts failed because of rejection. The average keratometry was 44.1 +/- 1.0 diopters (D), and the mean spherical equivalent was -3.23 +/- 2.86 D. The oversized grafts provided a mean anterior chamber depth of 2.36 +/- 0.42 mm, and the mean intraocular pressure at the 12 month follow-up was 16.38 +/- 2.09 mmHg.


CONCLUSIONS
Corneal grafts oversized by 1 mm provide adequate anterior chamber depth and reduce the risk of peripheral anterior synechiae and secondary glaucoma in patients with corneal opacities and extensive peripheral iridocorneal adhesions.
Vajpayee
R B
RB
Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
Dada
T
T
Ray
M
M
Tandon
R
R
Sethi
A
A
Turaka
K
K
D000293:Adolescent; D000328:Adult; D000368:Aged; D000867:Anterior Chamber / Q000033:anatomy & histology; D003315:Cornea / Q000033:anatomy & histology; D003318:Corneal Opacity / Q000601:surgery*; D005260:Female; D005901:Glaucoma / Q000517:prevention & control; D006085:Graft Survival; D006801:Humans; D007429:Intraocular Pressure; D007499:Iris Diseases / Q000517:prevention & control / Q000601:surgery*; D015948:Keratoplasty, Penetrating / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012029:Refraction, Ocular; D000267:Tissue Adhesions / Q000517:prevention & control / Q000601:surgery; D014019:Tissue Donors; D014792:Visual Acuity