Br J Ophthalmol 1998;82:1276-1279 ( November )
Corneoscleral transplantation for end stage corneal disease
Lawrence W Hirst,
Graham A Lee
Division of
Ophthalmology, Department of Surgery, University of Queensland,
Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
Correspondence to: Professor Lawrence W Hirst, 2nd Floor Lions Building,
Princess Alexandra Hospital, Ipswich Road, Woolloongabba, Queensland,
Australia, 4102.
Accepted for publication 21
April 1998
AIM
To describe the prognosis and complications of
corneoscleral transplantation in the management of end stage eye disease.
METHODSA case series is presented of 23 patients
who have undergone corneoscleral transplantation (
11 mm). Patients
were examined for visual acuity, intraocular pressure, recurrence of
disease process, epithelialisation of the graft, signs of rejection,
and other potential complications.
RESULTS14 patients retained their eye, with six
maintaining a clear graft. Vision ranged from 6/30 to no perception of
light. 13 patients developed glaucoma (range 25-69 mm Hg), with six
patients requiring surgical intervention. 12 patients required
tarsorrhaphy to promote epithelialisation. Only two grafts resulted in
typical rejection.
CONCLUSIONSThe technique of corneoscleral
transplantation can salvage otherwise end stage eye disease, but the
results are poor with respect to maintenance of vision. These patients
need careful follow up because of potential complications of glaucoma,
epithelial defects, rejection, and recurrence of disease.
Keywords:
corneoscleral graft;
end stage corneal disease;
sclerokeratoplasty
© 1998 by British Journal of Ophthalmology
