Kubaloglu Anil, Koytak Arif, Sogutlu Esin, Kurnaz Ekrem, Ozerturk Yusuf
Kartal Training and Research Hospital, Istanbul - Turkey.
Eur J Ophthalmol. 2010 Jan-Feb;20(1):35-40.
The aim of this study is to evaluate the long-term therapeutic outcomes and potential intraoperative and postoperative complications of penetrating keratoplasty in keratoconic eyes with prior radial keratotomy.
In this retrospective study, we reviewed the clinical data for keratoconic eyes with prior radial keratotomy that underwent penetrating keratoplasty between 1995 and 2007.
Data were obtained from 16 patients (24 eyes). The mean time interval between radial keratotomy and penetrating keratoplasty was 50.2 months. The mean postoperative follow-up period was 33.7 months. The mean best spectacle-corrected visual acuity (BSCVA) improved from 20/342 (range: 20/1200 to 20/100) preoperatively to 20/32 (range: 20/100 to 20/16) at the last control visit (p<0.05). None of the eyes had a preoperative BSCVA better than 20/100, while 91.7% of the eyes had a BSCVA of 20/40 or better at the end of the follow-up period. The mean keratometric astigmatism was 8.03 diopters preoperatively as compared with 3.63 diopters at the end of the follow-up period. There were no intraoperative complications. Six eyes (25.0%) experienced at least one episode of immunologic graft rejection during the follow-up period. One eye required a new corneal transplantation because of graft failure.
Penetrating keratoplasty for treating keratoconic eyes with previous radial keratotomy provides good visual outcomes and low graft rejection rates. We did not encounter any intraoperative difficulty related to the previous radial keratotomy. However, more caution during the keratoplasty is needed to overcome possible incision-related complications that may negatively affect the surgery and its outcome.
本研究旨在评估穿透性角膜移植术治疗既往接受过放射状角膜切开术的圆锥角膜患者的长期治疗效果以及潜在的术中及术后并发症。
在这项回顾性研究中，我们回顾了1995年至2007年间接受穿透性角膜移植术的既往有放射状角膜切开术史的圆锥角膜患者的临床资料。
数据来自16例患者（24只眼）。放射状角膜切开术与穿透性角膜移植术之间的平均时间间隔为50.2个月。术后平均随访期为33.7个月。平均最佳矫正视力（BSCVA）从术前的20/342（范围：20/1200至20/100）提高到最后一次复查时的20/32（范围：20/100至20/16）（p<0.05）。术前没有一只眼的BSCVA优于20/100，而在随访期结束时，91.7%的眼BSCVA达到20/40或更好。术前平均角膜散光为8.03屈光度，随访期结束时为3.63屈光度。术中无并发症。6只眼（25.0%）在随访期间经历了至少一次免疫性移植排斥反应。一只眼因移植失败需要再次进行角膜移植。
穿透性角膜移植术治疗既往有放射状角膜切开术史的圆锥角膜可提供良好的视力结果和较低的移植排斥率。我们未遇到与既往放射状角膜切开术相关的术中困难。然而，角膜移植术中需要更加谨慎，以克服可能对手术及其结果产生负面影响的与切口相关的并发症。
