Combined corneal allotransplantation and vitreoretinal surgery using an Eckardt temporary keratoprosthesis: analysis for factors determining corneal allograft survival

Dae Seung Lee,1 Jang Won Heo,1 Hyuk Jin Choi,2 Mee Kum Kim,1 Won Ryang Wee,1 Joo Youn Oh1 1Department of Ophthalmology, Seoul National University Hospital, 2Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Korea Purpose: To evaluate the outcome of corneal allotransplanta...

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Autores principales:	Lee DS, Heo JW, Choi HJ, Kim MK, Wee WR, Oh JY
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2014
Materias:	Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/f320e1cb2d9441f29107f8f688005372
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spelling	oai:doaj.org-article:f320e1cb2d9441f29107f8f6880053722021-12-02T02:36:51ZCombined corneal allotransplantation and vitreoretinal surgery using an Eckardt temporary keratoprosthesis: analysis for factors determining corneal allograft survival1177-5483https://doaj.org/article/f320e1cb2d9441f29107f8f6880053722014-02-01T00:00:00Zhttp://www.dovepress.com/combined-corneal-allotransplantation-and-vitreoretinal-surgery-using-a-a15948https://doaj.org/toc/1177-5483 Dae Seung Lee,1 Jang Won Heo,1 Hyuk Jin Choi,2 Mee Kum Kim,1 Won Ryang Wee,1 Joo Youn Oh1 1Department of Ophthalmology, Seoul National University Hospital, 2Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Korea Purpose: To evaluate the outcome of corneal allotransplantation in combined penetrating keratoplasty and vitreoretinal surgery using a temporary keratoprosthesis, and to determine the factors affecting corneal allograft survival. Methods: We reviewed the medical charts of eleven patients who had undergone combined corneal allotransplantation and pars plana vitrectomy using an Eckardt temporary keratoprosthesis, for the treatment of corneal opacification and vitreoretinal disease. The survival rates of the corneal grafts were assessed, and patient demographics, the diagnosis of corneal and retinal disease, the preoperative ocular characteristics, and surgical methods were compared between the group with graft survival and that with graft failure. Results: The causes of corneal opacification were corneal laceration (four eyes), infectious keratitis (four eyes), atopic keratitis (one eye), rejected corneal graft (one eye), and uveitis-related bullous keratopathy (one eye). The preoperative diagnoses included endophthalmitis (six eyes), posterior uveitis (one eye), vitreous opacity or hemorrhage (two eyes), and rhegmatogenous retinal detachment (two eyes). The survival rate of the corneal allografts was 27.3% (3/11 eyes). The mean survival time was 391 days during the mean follow-up period of 687 days. The retinal surgery was successful in 81.8% (9/11 eyes) of cases. The presence of active inflammation in the cornea at the time of surgery was significantly correlated with graft rejection (P=0.004). Other factors, including age, the presence of glaucoma, type of corneal and retinal disease, or type of retinal surgery, such as silicone oil injection and gas tamponade, had no significant correlation with graft rejection. Conclusion: Combined corneal allotransplantation and pars plana vitrectomy using a temporary keratoprosthesis allowed for successful surgical intervention in vitreoretinal disease. However, only 27.3% of corneal allografts survived, depending on the presence of active inflammation in the cornea. Keywords: corneal transplantation, vitrectomy, inflammationLee DSHeo JWChoi HJKim MKWee WROh JYDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2014, Iss default, Pp 449-454 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ophthalmology RE1-994
spellingShingle	Ophthalmology RE1-994 Lee DS Heo JW Choi HJ Kim MK Wee WR Oh JY Combined corneal allotransplantation and vitreoretinal surgery using an Eckardt temporary keratoprosthesis: analysis for factors determining corneal allograft survival
description	Dae Seung Lee,1 Jang Won Heo,1 Hyuk Jin Choi,2 Mee Kum Kim,1 Won Ryang Wee,1 Joo Youn Oh1 1Department of Ophthalmology, Seoul National University Hospital, 2Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Korea Purpose: To evaluate the outcome of corneal allotransplantation in combined penetrating keratoplasty and vitreoretinal surgery using a temporary keratoprosthesis, and to determine the factors affecting corneal allograft survival. Methods: We reviewed the medical charts of eleven patients who had undergone combined corneal allotransplantation and pars plana vitrectomy using an Eckardt temporary keratoprosthesis, for the treatment of corneal opacification and vitreoretinal disease. The survival rates of the corneal grafts were assessed, and patient demographics, the diagnosis of corneal and retinal disease, the preoperative ocular characteristics, and surgical methods were compared between the group with graft survival and that with graft failure. Results: The causes of corneal opacification were corneal laceration (four eyes), infectious keratitis (four eyes), atopic keratitis (one eye), rejected corneal graft (one eye), and uveitis-related bullous keratopathy (one eye). The preoperative diagnoses included endophthalmitis (six eyes), posterior uveitis (one eye), vitreous opacity or hemorrhage (two eyes), and rhegmatogenous retinal detachment (two eyes). The survival rate of the corneal allografts was 27.3% (3/11 eyes). The mean survival time was 391 days during the mean follow-up period of 687 days. The retinal surgery was successful in 81.8% (9/11 eyes) of cases. The presence of active inflammation in the cornea at the time of surgery was significantly correlated with graft rejection (P=0.004). Other factors, including age, the presence of glaucoma, type of corneal and retinal disease, or type of retinal surgery, such as silicone oil injection and gas tamponade, had no significant correlation with graft rejection. Conclusion: Combined corneal allotransplantation and pars plana vitrectomy using a temporary keratoprosthesis allowed for successful surgical intervention in vitreoretinal disease. However, only 27.3% of corneal allografts survived, depending on the presence of active inflammation in the cornea. Keywords: corneal transplantation, vitrectomy, inflammation
format	article
author	Lee DS Heo JW Choi HJ Kim MK Wee WR Oh JY
author_facet	Lee DS Heo JW Choi HJ Kim MK Wee WR Oh JY
author_sort	Lee DS
title	Combined corneal allotransplantation and vitreoretinal surgery using an Eckardt temporary keratoprosthesis: analysis for factors determining corneal allograft survival
title_short	Combined corneal allotransplantation and vitreoretinal surgery using an Eckardt temporary keratoprosthesis: analysis for factors determining corneal allograft survival
title_full	Combined corneal allotransplantation and vitreoretinal surgery using an Eckardt temporary keratoprosthesis: analysis for factors determining corneal allograft survival
title_fullStr	Combined corneal allotransplantation and vitreoretinal surgery using an Eckardt temporary keratoprosthesis: analysis for factors determining corneal allograft survival
title_full_unstemmed	Combined corneal allotransplantation and vitreoretinal surgery using an Eckardt temporary keratoprosthesis: analysis for factors determining corneal allograft survival
title_sort	combined corneal allotransplantation and vitreoretinal surgery using an eckardt temporary keratoprosthesis: analysis for factors determining corneal allograft survival
publisher	Dove Medical Press
publishDate	2014
url	https://doaj.org/article/f320e1cb2d9441f29107f8f688005372
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Combined corneal allotransplantation and vitreoretinal surgery using an Eckardt temporary keratoprosthesis: analysis for factors determining corneal allograft survival

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