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Penetrating Keratoplasty After Epikeratophakia for Keratoconus

Penetrating Keratoplasty After Epikeratophakia for Keratoconus Abstract • Seven patients underwent penetrating keratoplasty after epikeratophakia for keratoconus. All seven patients achieved clear grafts and 20/40 or better best corrected visual acuity after penetrating keratoplasty. Three of the seven patients had one or more episodes of rejection after penetrating keratoplasty; all were treated successfully. No grafts were lost. The results in terms of graft clarity and visual acuity are comparable with those in patients undergoing penetrating keratoplasty for keratoconus with no previous ocular surgery. Whether the relatively high rate of rejection episodes (three [43%]) seen in this small number of patients indicates some relationship between previous epikeratophakia and subsequent rejection after penetrating keratoplasty remains to be seen. References 1. Paglen PG, Fine M, Abbott RL, et al: The prognosis for keratoplasty in keratoconus . Ophthalmology 1982;89:651-654.Crossref 2. Kaufman HE, Werblin TP: Epikeratophakia for the treatment of keratoconus . Am J Ophthalmol 1982;93:342-347. 3. McDonald MB, Koenig JB, Safir A, et al: Onlay lamellar keratoplasty for the treatment of keratoconus . Br J Ophthalmol 1983;67:615-618.Crossref 4. McDonald MB, Kaufman HE, Durrie DS, et al: Epikeratophakia for keratoconus: The nationwide study . Arch Ophthalmol 1986;104:1294-1300.Crossref 5. Safir A, McDonald MB, Klyce SD, et al: The cornea press: Restoring donor corneas to normal dimensions and hydration before cryolathing . Ophthalmic Surg 1983;14:327-331. 6. McDonald MB, Kaufman HE: Epikeratophakia for aphakia, myopia, and keratoconus , in Waltman SR, Keates RH, Hoyt CS, et al (eds): Surgery of the Eye . New York, Churchill Livingstone, 1988, vol 1, pp 243-261. 7. Donshik PC, Cavanagh HD, Boruchoff SA, et al: Effect of bilateral and unilateral grafts on the incidence of rejections in keratoconus . Am J Ophthalmol 1979;87:823-826. 8. Ehlers N, Olsen T: Long term results of corneal grafting in keratoconus . Acta Ophthalmol 1983;61:918-926.Crossref 9. Troutman RC, Gaster RN: Surgical advances and results of keratoconus . Am J Ophthalmol 1980;90:131-136. 10. Goodman GL, Peiffer RL, Werblin TP: Failed epikeratoplasty for keratoconus . Cornea 1986;5:29-34.Crossref 11. Jaeger MJ, Berson P, Kaufman HE, et al: Epikeratoplasty for keratoconus: A clinicopathologic case report . Cornea 1987;6:131-139.Crossref 12. Anseth A: Keratoplasty for keratoconus: A report of 50 operated eyes . Acta Ophthalmol 1967;45:684-687.Crossref 13. Chandler JW, Kaufman HE: Graft reactions after keratoplasty for keratoconus . Am J Ophthalmol 1974;77:543-547. 14. Buxton GN, Schuman M, Pecogo J: Graft reactions after unilateral and bilateral keratoplasty for keratoconus . Ophthalmology 1981;88:771-773.Crossref 15. Meyer RF: Corneal allograft rejection in bilateral penetrating keratoplasty: Clinical and laboratory studies . Trans Am Ophthalmol Soc 1986;84:664-742. 16. Moore MB, Gebhardt BM, Verity SM, et al: Fate of lyophilized xenogenic corneal lenticules in intrastromal implantation and epikeratophakia . Invest Ophthalmol Vis Sci 1987;28:555-559. 17. Binder PS, Zavala EY, Baumgartner SD, et al: Combined morphologic effects of cryolathing and lyophilization on epikeratoplasty lenticules . Arch Ophthalmol 1986;104:671-679.Crossref 18. Zavala EY, Binder PS, Deg JK, et al: Refractive keratoplasty: Lathing and cryopreservation . CLAO J 1985;11:155-162. 19. Schanzlin DJ, Jester JV, Kay ED: Cryolathe corneal injury . Cornea 1983;2:57-68.Crossref 20. Polack FM, McEntyre JM: Incorporation of sodium sulfate S35 by cryopreserved corneal grafts in vivo . Arch Ophthalmol 1969;81:577-582.Crossref 21. Gebhardt BM: Factors affecting corneal allograft rejection in inbred rats . Transplant Proc 1981;13:1091-1093. 22. Donshik PC, Cavanagh HD, Boruchoff SA, et al: Posterior subcapsular cataracts induced by topical corticosteroids following keratoplasty for keratoconus . Ann Ophthalmol 1981;13:29-32. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Ophthalmology American Medical Association

Penetrating Keratoplasty After Epikeratophakia for Keratoconus

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Publisher
American Medical Association
Copyright
Copyright © 1988 American Medical Association. All Rights Reserved.
ISSN
0003-9950
eISSN
1538-3687
DOI
10.1001/archopht.1988.01060140384038
Publisher site
See Article on Publisher Site

Abstract

Abstract • Seven patients underwent penetrating keratoplasty after epikeratophakia for keratoconus. All seven patients achieved clear grafts and 20/40 or better best corrected visual acuity after penetrating keratoplasty. Three of the seven patients had one or more episodes of rejection after penetrating keratoplasty; all were treated successfully. No grafts were lost. The results in terms of graft clarity and visual acuity are comparable with those in patients undergoing penetrating keratoplasty for keratoconus with no previous ocular surgery. Whether the relatively high rate of rejection episodes (three [43%]) seen in this small number of patients indicates some relationship between previous epikeratophakia and subsequent rejection after penetrating keratoplasty remains to be seen. References 1. Paglen PG, Fine M, Abbott RL, et al: The prognosis for keratoplasty in keratoconus . Ophthalmology 1982;89:651-654.Crossref 2. Kaufman HE, Werblin TP: Epikeratophakia for the treatment of keratoconus . Am J Ophthalmol 1982;93:342-347. 3. McDonald MB, Koenig JB, Safir A, et al: Onlay lamellar keratoplasty for the treatment of keratoconus . Br J Ophthalmol 1983;67:615-618.Crossref 4. McDonald MB, Kaufman HE, Durrie DS, et al: Epikeratophakia for keratoconus: The nationwide study . Arch Ophthalmol 1986;104:1294-1300.Crossref 5. Safir A, McDonald MB, Klyce SD, et al: The cornea press: Restoring donor corneas to normal dimensions and hydration before cryolathing . Ophthalmic Surg 1983;14:327-331. 6. McDonald MB, Kaufman HE: Epikeratophakia for aphakia, myopia, and keratoconus , in Waltman SR, Keates RH, Hoyt CS, et al (eds): Surgery of the Eye . New York, Churchill Livingstone, 1988, vol 1, pp 243-261. 7. Donshik PC, Cavanagh HD, Boruchoff SA, et al: Effect of bilateral and unilateral grafts on the incidence of rejections in keratoconus . Am J Ophthalmol 1979;87:823-826. 8. Ehlers N, Olsen T: Long term results of corneal grafting in keratoconus . Acta Ophthalmol 1983;61:918-926.Crossref 9. Troutman RC, Gaster RN: Surgical advances and results of keratoconus . Am J Ophthalmol 1980;90:131-136. 10. Goodman GL, Peiffer RL, Werblin TP: Failed epikeratoplasty for keratoconus . Cornea 1986;5:29-34.Crossref 11. Jaeger MJ, Berson P, Kaufman HE, et al: Epikeratoplasty for keratoconus: A clinicopathologic case report . Cornea 1987;6:131-139.Crossref 12. Anseth A: Keratoplasty for keratoconus: A report of 50 operated eyes . Acta Ophthalmol 1967;45:684-687.Crossref 13. Chandler JW, Kaufman HE: Graft reactions after keratoplasty for keratoconus . Am J Ophthalmol 1974;77:543-547. 14. Buxton GN, Schuman M, Pecogo J: Graft reactions after unilateral and bilateral keratoplasty for keratoconus . Ophthalmology 1981;88:771-773.Crossref 15. Meyer RF: Corneal allograft rejection in bilateral penetrating keratoplasty: Clinical and laboratory studies . Trans Am Ophthalmol Soc 1986;84:664-742. 16. Moore MB, Gebhardt BM, Verity SM, et al: Fate of lyophilized xenogenic corneal lenticules in intrastromal implantation and epikeratophakia . Invest Ophthalmol Vis Sci 1987;28:555-559. 17. Binder PS, Zavala EY, Baumgartner SD, et al: Combined morphologic effects of cryolathing and lyophilization on epikeratoplasty lenticules . Arch Ophthalmol 1986;104:671-679.Crossref 18. Zavala EY, Binder PS, Deg JK, et al: Refractive keratoplasty: Lathing and cryopreservation . CLAO J 1985;11:155-162. 19. Schanzlin DJ, Jester JV, Kay ED: Cryolathe corneal injury . Cornea 1983;2:57-68.Crossref 20. Polack FM, McEntyre JM: Incorporation of sodium sulfate S35 by cryopreserved corneal grafts in vivo . Arch Ophthalmol 1969;81:577-582.Crossref 21. Gebhardt BM: Factors affecting corneal allograft rejection in inbred rats . Transplant Proc 1981;13:1091-1093. 22. Donshik PC, Cavanagh HD, Boruchoff SA, et al: Posterior subcapsular cataracts induced by topical corticosteroids following keratoplasty for keratoconus . Ann Ophthalmol 1981;13:29-32.

Journal

Archives of OphthalmologyAmerican Medical Association

Published: Sep 1, 1988

References