Long-Term Outcomes of Two-Piece Mushroom Keratoplasty for Traumatic Corneal Scars.
Yu Angeli Christy, Spena Rossella, Fusco Fiorella, Dondi Riccardo, Myerscough James, Fabbri Federica, Bovone Cristina, Busin Massimo
AI Summary
Two-piece mushroom keratoplasty for traumatic corneal scars showed excellent long-term visual improvement with stable endothelial cells and low rejection, offering a good treatment option.
Abstract
Purpose
To report the outcomes of 2-piece microkeratome-assisted mushroom keratoplasty (MK) for eyes with full-thickness traumatic corneal scars and otherwise functional endothelium following corneal penetrating injury.
Design
This was an interventional case series.
Methods
In this single-center study, 41 consecutive eyes with traumatic corneal scars that underwent 2-piece microkeratome-assisted mushroom keratoplasty were evaluated. The 2-piece mushroom graft consisted of an anterior lamella 9 mm in diameter and a posterior lamella 6 mm in diameter. Outcome measures were best spectacle-corrected visual acuity (BSCVA), refractive astigmatism (RA), endothelial cell density, and postoperative complication rates.
Results
Of the 41 total cases, 38 eyes (93%) reached Snellen vision ≥20/100, 36 (88%) reached ≥20/60, 29 (71%) reached ≥20/40, and 13 (32%) reached ≥20/25 2 years following MK. Excluding eyes with vision-impairing comorbidities, baseline logMAR BSCVA (1.41 ± 0.73) significantly improved annually during the first 2 years (P < 0.001), reaching 0.16 ± 0.13 at year 2, which subsequently remained stable up to 10 years (P = .626). The RA exceeded 4.5 diopters in 2 cases (5%) after wound revision for high-degree astigmatism in 5 cases. Endothelial cell loss was 35.1% at 1 year, with an annual decline of 2.9% over 10 years. Elevation in IOP was observed postoperatively in 7 eyes, of which 6 had pre-existing glaucoma. The 10-year cumulative risk for graft rejection and failure was 8.5% and 10%, respectively.
Conclusion
Two-piece microkeratome-assisted MK for traumatic corneal scars can allow excellent visual rehabilitation with relatively stable ECL and low rates of immunologic rejection and graft failure.
MeSH Terms
Shields Classification
Key Concepts5
Two-piece microkeratome-assisted mushroom keratoplasty for traumatic corneal scars resulted in 38 out of 41 eyes (93%) achieving Snellen vision ≥20/100, 36 (88%) achieving ≥20/60, 29 (71%) achieving ≥20/40, and 13 (32%) achieving ≥20/25 two years following the procedure.
Excluding eyes with vision-impairing comorbidities, baseline logMAR BSCVA (1.41 0.73) significantly improved annually during the first 2 years (P < 0.001) to 0.16 0.13 at year 2, and subsequently remained stable up to 10 years (P = .626) following two-piece microkeratome-assisted mushroom keratoplasty for traumatic corneal scars.
Following two-piece microkeratome-assisted mushroom keratoplasty for traumatic corneal scars, endothelial cell loss was 35.1% at 1 year, with an annual decline of 2.9% over 10 years.
The 10-year cumulative risk for graft rejection and failure following two-piece microkeratome-assisted mushroom keratoplasty for traumatic corneal scars was 8.5% and 10%, respectively.
Elevation in IOP was observed postoperatively in 7 eyes following two-piece microkeratome-assisted mushroom keratoplasty for traumatic corneal scars, of which 6 had pre-existing glaucoma.
Related Articles5
Risk Factors for Intraocular Pressure Elevation in Steep Trendelenburg Position During Surgery.
Observational StudyArtificial Intelligence in Predicting Ocular Hypertension After Descemet Membrane Endothelial Keratoplasty.
Cohort StudyFinite Element Analysis of Mechanical Ocular Sequelae from Badminton Shuttlecock Projectile Impact.
Basic ScienceFirst-eye intraocular pressure spike as a predictor of second-eye spike in cataract surgery.
Observational StudyCharacterization of Ocular Injuries Caused by Orbeez Hydrated Gel Pellet Projectiles: Clinical Insights and Implications.
Case SeriesIs this article assigned to the wrong chapter(s)? Let us know.