[One-piece mushroom keratoplasty outcomes].

PURPOSE: To clinically evaluate the results of one-piece mushroom-shaped keratoplasty.

MATERIAL AND

METHODS

A total of 10 patients (10 eyes) were enrolled, all having corneal perforations and deep stromal opacities with involvement of Descemet's membrane. For transplantation, hypothermic preserved donor corneas with mean endothelial cell density of 2896±327 cells per 1 mm2 were used. Surgical technique. Recipient tissues as well as the graft were cut with the Moria trephine. For that, the 8.5-mm blade was replaced by a 6.5-mm one and vice versa, respectively, with attention paid not to violate the vacuum while making the cuts.

RESULTS

Transparent cornea engraftment was achieved in all patients. Best corrected visual acuity averaged 0.55±0.22. Spherical component of refraction varied from -4.25 to +2.75 diopters. Mean corneal astigmatism was 3.35±1.73 diopters. At 6 months after surgery, the mean endothelial cell density was 2355±336 cells/mm2, at 1 year - 2141±304 cells/mm2.

CONCLUSION

One-piece mushroom keratoplasty is an effective surgical treatment of corneal perforations and deep stromal opacities with involvement of Descemet's membrane that ensures a high rate of transparent corneal engraftment. The use of the Moria vacuum trephine in combination with blades of different diameters and secure fixation of the vacuum part of the trephine eliminate the risk of the 'mushroom stem' decentration relative to its 'head'.