Evaluation of different types of lamellar keratoplasty for treatment of peripheral corneal perforation.

BACKGROUND

To discuss the efficacy and visual outcomes of different types of lamellar keratoplasty (LK) for the treatment of peripheral corneal perforation.

METHODS

Sixty patients (67 eyes) with peripheral corneal perforation underwent semilunar LK (16 eyes), crescentic LK (12 eyes), biconvex LK (13 eyes), annular LK (11 eyes) and total LK (15 eyes) respectively. The applied type of LK for each involved eye was decided by different sizes and shapes of corneal ulceration and perforation. Postoperative visual acuity (VA), corneal astigmatism and postoperative complications were studied during a 7- to 21-month follow-up.

RESULTS

VA showed no statistical difference preoperatively (P = 0.18), but it was statistically different postoperatively (P < 0.01) in eyes with different types of LK. Postoperative VA in eyes with semilunar LK, crescentic LK and total LK was statistically better than that before surgery (all P values <0.05). Postoperative corneal astigmatism in different types of LK was statistically different (P < 0.01). Semilunar and crescentic LK had the lowest astigmatism, while biconvex LK had the highest. The main postoperative complications were leakage at the graft-host interface, graft rejection and initial disease recurrence.

CONCLUSION

LK is an effective procedure in eyes with peripheral corneal perforation. Different sizes and shapes of LK can influence postoperative VA due to different degrees of astigmatism. Yet postoperative astigmatism can be reduced by making well-matched grafts and preserving the uninvolved tissue to the largest extent.