pm mfvt1
    • Main page
      • About journal
      • Articles. Working with contents
      • Editor-in-chief
      • Editorial Council
      • Editorial Board


      • For authors
      • Standards for formatting information
      • Reviewing
      • Politics editorial board
      • Ethics of journal publications


      • For advertisers
      • Subscription
      • About the Publishing House
      • Contact us
  • Keratoplasty with rare forms of idiopathic and iatrogenic ectasia of the cornea

    Редактор | 2017, Practical medicine 09 (17) Ophthalmology. Part 2 | 6 сентября, 2017

    N.Ya. SENCHENKO1, T.N. YURYEVA1,2

    1Irkutsk branch of the S. Fyodorov Eye Microsurgery Federal State Institution, 337 Lermontov Str., Irkutsk, Russian Federation, 664033

    2Irkutsk State Medical Academy — Branch Campus of the RMACPE MOH Russia, 100 Yubileyniy district, Irkutsk, Russian Federation, 664079

      Senchenko N.Y. — Cand. Med. Sc., Head of the 1st Surgical Department, tel. +7-914-941-30-93, e-mail: nadezdasenchenko@gmail.com

    Yuryeva T.N. — D. Med. Sc., Professor, Deputy Director on Scientific Work, Professor of the Departments of Eye Diseases, tel. +7-914-926-72-90, e-mail: tnyurieva@mail.ru

     The article presents the results of analysis of clinical efficiency of penetrating keratoplasty in severe idiopathic and iatrogenic forms of corneal ectasia. 9 patients were operated, 3 of them for pellucidal marginal degeneration of the cornea and 6 — for keratectasia due to refractive interventions. 4 patients at the same time underwent cataract phacoemulsification with implantation of an elastic intraocular lens (3 cases) and a monoblock “artificial iris-IOL” (1 case). The biological and functional results were evaluated 1 year after the operation. Transparent transplant engraftment was achieved in all cases. Epithelial cell density (ECD) in patients with pellucidal marginal degeneration of the cornea was 2123±248 cells/mm2, with induced ecstasia — 2365±118 cells/mm2. Losses of ECD ranged from 18% to 32%. In patients with iatrogenic ectasia, the highest visual functions were achieved — on average 0.5±0.05 without correction and 0.8±0.02 with correction. In the case of pellucid marginal degeneration of the cornea, the visual acuity was 0.2 ± 0.01 and 0.35 ± 0.05, respectively. In general, high efficiency of penetrating keratoplasty was noted in ectasia, characterized by pronounced deformation and or atypical thinning of the cornea in theperipheral prelimbal zone.

    Key words: ectasia, idiopathic, iatrogenic, keratoplasty, keratotomy, keratomileusis, complications.

    REFERENCES

    1. Bikbov M.M., Bikbova G.M. Ektazii rogovitsy (patogenez, patomorfologiya, klinika, diagnostika, lechenie) [Corneal ectasia (pathogenesis, pathomorphology, clinic, diagnosis, treatment)]. Moscow: Oftal’mologiya, 2011. 164 p.
    2. Gomes J.A., Rapuano C.J., Belin M.W., Ambrósio R. Jr. Group of Panelists for the Global Delphi Panel of Keratoconus and Ectatic Diseases. Global Consensus on Keratoconus Diagnosis. Cornea, 2015, 12.
    3. Rabinowitz Y.S. Keratoconus. Surv. Ophthalmol, 1998, vol. 42, no. 4, pp. 297–319.
    4. Dronov M.M., Pirogov Yu.I. Keratoconus (species, etiology and pathogenesis). Part I. Oftal’mokhirurgiya i terapiya, 2002, no. 1, pp. 33–38 (in Russ.).
    5. Maharana P.K., Dubey A., Jhanji V. et al. Management of Advanced Corneal Ectasias. Br. J. Ophthalmol, 2016, vol. 100, pp. 34–40.
    6. Elder M.J. Leber congenital amaurosis and its association with keratoconus and keratoglobus. J. Pediatr. Ophtalmol.Strabismus, 1994, vol. 31 (1), pp. 38–40.
    7. Hyams S.W., Kar H., Neumann E. Blue sclerae and keratoglobus. Ocular signs of a systemic connective tissue disorder. Br. J. Ophthalmol, 1969, vol.53 (1), pp. 53–58.
    8. Meghpara B., Nakamura H., Vemuganti et al. Histopathologic and immunohistochemical studies of keratoglobus. Arch. Ophthalmol, 2009, vol.127, no. 8, pp. 1029–1035.
    9. Krachmer J.H. Pellucid marginal corneal degeneration. Arch. Ophthalmol, 1978, vol. 96 (7), pp. 1217–1221.
    10. Sridhar M.S., Mahesh S., Bansal A.K. et al. Pellucid marginal corneal degeneration. Ophthalmology, 2004, vol. 111, pp. 1102–1107.
    11. Thurschwell L.M. Terrien’s marginal degeneration. J. Am. Ophom. Assoc, 1983, vol. 54, no. 5, pp. 441–446.
    1. Seiler T., Quurke A.W. Iatrogenic keratectasia after LASIK in case of formefrustekeratoconus. J. Cataract. Refract. Surg, 1998, vol. 24, no. 7, pp. 1007–1009.
    2. Schmitt-Bernard C.F., Lesaqe C., Arnaud B. Keratectasia induced by laser in situ keratomileusis in keratoconus. J. Refract. Surg, 2000, vol. 16, no. 3, pp. 368–370.
    3. Binder P.S., Lindstrom R.L., Stulting R.D. et al. Keratoconus and corneal ectasia after LASIK. J. Cataract Refract. Surg, 2005, vol.31 (11), pp. 2035–2038.
    4. Shchuko A.G., Grebenyuk T.N., Yur’eva E.N. et al. Risk factors and methods for predicting induced ectases. Kataraktal’naya i refraktsionnaya khirurgiya, 2013, vol. 13, no. 4, pp. 53–56 (in Russ.).
    5. Shaikh S., Shaikh N.M., Manche E. Iatrogenickeratoconusasacomplicationofradialkeratotomy. J.Cataract Refract. Surg, 2002, vol. 28, no. 3, pp. 553–5.
    6. Bikbulatova A.A., Pasikova N.V. Iatrogenic keratectasia as a distant complication of anterior keratotomy. Vestnik Orenburgskogo gosudarstvennogo universiteta, 2015, no. 12 (187), pp. 38–41 (in Russ.).
    7. Senchenko N.Ya., Rozanova O.I., Shanturova M.A. et al. Optimization of the calculation of the optical power of toric IOL in patients with cataract and altered corneal topography. Oftal’mokhirurgiya, 2016, no. 1, pp. 6–13 (in Russ.).
    8. Bikbov M.M., Bikbova G.M. Modern aspects of keratoconus surgery. Vestnik Orenburgskogo gosudarstvennogo universiteta, 2008, no. 12–2 (94), pp. 23–24 (in Russ.).
    9. Solodkova E.G., Remesnikov I.A. Modern approaches in the treatment of progressive keraectasia. Prakticheskaya meditsina, 2012, no. 4–1 (59), pp. 75–79 (in Russ.).

    Метки: 2017, complications, ectasia, iatrogenic, idiopathic, keratomileusis, keratoplasty, keratotomy, N.Ya. SENCHENKO, Practical medicine 09 (17) Ophthalmology. Part 2, T.N. YURYEVA

    ‹ Morphological analysis of «Alloplant» implanted in the eyeball wall under the conditions of its experimental subatrophy Traditional ophthalmic research methods and ROC-analysis of perimetry in the diagnosis of neurodegeneration in patients with demyelinating diseases ›
    • rus Версия на русском языке


      usa English version site


      Find loupe

      

    • PARTNERS

      пов  logonew
    «Для
    Practical medicine. Scientific and practical reviewed medical journal
    All rights reserved ©