[Keratoplasty with 11-12 mm diameter for management of severely chemical-burned eyes].

Up to now 73 patients with 101 very severe eye burns have been operated on in our clinic. Thirty-nine patients were treated by a penetrating keratoplasty. More than 1 year after the accident 8 patients were treated with keratoplasties, 11-12 mm in diameter. These large diameters were necessary, because 6 patients developed widespread progressive corneal ulcerations, and in 2 patients the artificial epithelium failed to protect the denuded corneal stroma and sloughed off because of deep stromal defects. The long-term follow-up in these cases is now at least 1 year. Six grafts remained clear with a healthy epithelial layer. The resulting visual acuity in these cases ranged from 0.1 to 0.5. Five patients developed a cataract secondary to the application of steroids. Two grafts were rejected in a very early period 2-3 months after transplantation. In corneal melting processes including the limbal region, treatment with large keratoplasties seems to be a possibility for long-lasting healing and rehabilitation in very severe eye burns. Important for the prognosis of the graft obviously is the restoration of an intact limbal region.