title: Surgical outcomes of perforated and unperforated corneal descemetocele.
abstract: OBJECTIVE
  To compare the surgical outcomes of amniotic membrane transplantation (AMT) and penetrating keratoplasty (PK) in perforated and non-perforated corneal descemetocele.
  
  
  METHODS
  In this study, we retrospectively examined 48 eyes of 48 patients operated with AMT, and 32 eyes of 32 patients operated with PK for perforated and non-perforated descemetocele.
  
  
  RESULTS
  There were no significant differences between the two groups with regard to age, sex, laterality, follow-up duration, cause of descemetocele, and localization (p > 0.05). Thirty-six (75%) eyes in the AMT group and 17 (53.1%) eyes in the PK group were perforated prior to operation (p = 0.043). Surgical success was achieved in 35 (73%) of 48 eyes underwent AMT and 28 (87.5%) of 32 eyes underwent PK (p = 0.118). Perforation size was the only parameter significantly affecting surgical success (AMT p = 0.001, PK p = 0.003). The visual acuity was significantly better at the postsurgical period compared to the presurgical period in both groups (p = 0.003, p < 0.001). It was observed that the postsurgical change in the visual acuity score was significantly greater in the PK group (p = 0.001).
  
  
  CONCLUSIONS
  Penetrating keratoplasty is superior to AMT for achieving ocular surface integrity and enhancing visual acuity. Amniotic membrane transplantation saves time for patients and surgeons when donor cornea supply is limited and it allows PK to be performed at a quiet period when inflammation is suppressed.
authors.affiliation: Department of Ophthalmology, Ankara Training and Research Hospital, Sukriye Mahallesi, Ulucanlar Caddesi, No:89 Altındag, 06340, Ankara, Turkey. evinsingar@yahoo.com.
authors.forename: Evin Singar
authors.initials: ES
authors.lastname: Ozdemir
authors.affiliation: Department of Ophthalmology, Ankara Training and Research Hospital, Sukriye Mahallesi, Ulucanlar Caddesi, No:89 Altındag, 06340, Ankara, Turkey.
authors.forename: Ayse
authors.initials: A
authors.lastname: Burcu
authors.affiliation: Department of Ophthalmology, Ankara Training and Research Hospital, Sukriye Mahallesi, Ulucanlar Caddesi, No:89 Altındag, 06340, Ankara, Turkey.
authors.forename: Zuleyha Yalnız
authors.initials: ZY
authors.lastname: Akkaya
authors.affiliation: Department of Ophthalmology, Ankara Training and Research Hospital, Sukriye Mahallesi, Ulucanlar Caddesi, No:89 Altındag, 06340, Ankara, Turkey.
authors.forename: Firdevs
authors.initials: F
authors.lastname: Ornek
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000650:Amnion / Q000637:transplantation*; D001684:Biological Dressings; D002648:Child; D003315:Cornea / Q000000981:diagnostic imaging / Q000601:surgery*; D003316:Corneal Diseases / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D057112:Corneal Perforation / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D003886:Descemet Membrane / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006085:Graft Survival; D006801:Humans; D015948:Keratoplasty, Penetrating; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care / Q000379:methods; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity; D055815:Young Adult
keywords: Amniotic membrane transplantation; Corneal descemetocele; Penetrating keratoplasty; Perforation