Penetrating keratoplasty combined with vitreoretinal surgery for severe ocular injury with blood-stained cornea and no light perception.

OBJECTIVE

To evaluate the effects of treatment of severe ocular injury with blood-stained cornea and no light perception by combined penetrating keratoplasty and vitreoretinal surgery, and to analyze the relevant factors.

METHODS

Records of 7 severely injured eyes of 7 patients with blood-stained cornea and no light perception who underwent penetrating keratoplasty combined with vitrectomy using a temporary keratoprosthesis were evaluated retrospectively. The preoperative visual acuity was no light perception in all injured eyes with a mean intraocular pressure of 3 mm Hg and a range from 2 to 5 mm Hg. The average interval from emergency wound closure to vitrectomy was 18 days with a range from 12 to 21 days. The mean follow-up was 28 months with a range from 26 to 30 months.

RESULTS

The postoperative visual acuity was better than light perception in 5 eyes with the best corrected visual acuity from light perception to 0.06. The retina was attached in 5 eyes. The postoperative intraocular pressure ranged from 5 to 15 mm Hg with a mean of 12 mm Hg; it was significantly higher than the preoperative one (p < 0.05). The postoperative complications mainly included temporary intraocular elevation (1 eye), corneal neovascularization (4 eyes), corneal rejection (4 eyes), retinal detachment (2 eyes) and ocular atrophy (2 eyes).

CONCLUSION

Penetrating keratoplasty combined with vitrectomy using a temporary keratoprosthesis is a safe and effective method in treating severe ocular injury with blood-stained cornea and no light perception.