Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft · 1997
[Keratoplasty of pseudophakic eyes with posterior chamber lenses in Fuchs' dystrophy and secondary bullous keratopathy. Long-term outcome].
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Müller M, Meyer H J, Meyer C
Аннотация
UNLABELLED: Penetrating keratoplasties in pseudophakia were added to a group with limited prognosis. This was especially valuable, if iris-supported and anterior chamber intraocular lenses were implanted. Since today mainly posterior chamber lenses are implanted, the question of the long-term prognosis in this type of lens is important.
PATIENTS AND METHOD: From 1985 to 1994, 62 penetrating keratoplasties in pseudophakic eyes with posterior chamber IOL were performed: group I: decompensated Fuchs dystrophy (26 patients), group II: secondary surgery-related bullous keratopathy (36 patients) exclusively. Minimal follow-up was 18 months, mean age was 73.7 years.
RESULTS: The mean follow-up period was 32 months. The mean visual acuity on delivery was 0.11. After 6 months it was 0.23, after 1 year 0.3, after 2 years 0.35 and after 3 years 0.41 without significant differences in either group. Two years after transplantation 52.8% gained a visual acuity (VA) of > or = 0.3, after 3 years 58.6% of which 41.1% had a VA of > or = 0.5. There was a visual improvement in 83.4%; the mean spherical equivalent was -0.29 D. Refractive errors within 2 D of emmetropia were found in 56.7%; 95.1% of the grafts remained clear. Five patients had a reversible graft rejection. Extracorneal factors of impaired vision were observed in 25 patients.
CONCLUSION: Despite a different VA before surgery, the visual outcome in the two groups was identical. Penetrating keratoplasty in Fuchs dystrophy and secondary bullous keratopathy with posterior chamber IOL have a much better long-term prognosis than those with iris-supported and anterior chamber IOL. Postoperative complications and graft rejections are rare.
PATIENTS AND METHOD: From 1985 to 1994, 62 penetrating keratoplasties in pseudophakic eyes with posterior chamber IOL were performed: group I: decompensated Fuchs dystrophy (26 patients), group II: secondary surgery-related bullous keratopathy (36 patients) exclusively. Minimal follow-up was 18 months, mean age was 73.7 years.
RESULTS: The mean follow-up period was 32 months. The mean visual acuity on delivery was 0.11. After 6 months it was 0.23, after 1 year 0.3, after 2 years 0.35 and after 3 years 0.41 without significant differences in either group. Two years after transplantation 52.8% gained a visual acuity (VA) of > or = 0.3, after 3 years 58.6% of which 41.1% had a VA of > or = 0.5. There was a visual improvement in 83.4%; the mean spherical equivalent was -0.29 D. Refractive errors within 2 D of emmetropia were found in 56.7%; 95.1% of the grafts remained clear. Five patients had a reversible graft rejection. Extracorneal factors of impaired vision were observed in 25 patients.
CONCLUSION: Despite a different VA before surgery, the visual outcome in the two groups was identical. Penetrating keratoplasty in Fuchs dystrophy and secondary bullous keratopathy with posterior chamber IOL have a much better long-term prognosis than those with iris-supported and anterior chamber IOL. Postoperative complications and graft rejections are rare.