Evaluation of the Cornea and Anterior Chamber Morphologic Changes After Penetrating Keratoplasty in Patients With Keratoconus

Objectives: To evaluate changes of the cornea and anterior chamber after penetrating keratoplasty in eyes with keratoconus. Methods: Medical records of 68 eyes of 68 patients with keratoconus who experienced penetrating keratoplasty at the Eye Clinic of Dr. Lütfi Kirdar Kartal Research and Training Hospital between 2010 and 2012 were studied. Records were retrospectively evaluated with regard to anterior chamber depth, iridocorneal angle, central corneal thickness, thinnest corneal thickness, maximum keratometric value, and mean keratometric value. Patients who developed complications and required additional surgery were excluded. Results: A total of 68 eyes of 68 patients were included in this study. There were 40 (58.8%) male and 28 (41.2%) female patients. The mean age was 24.5±8.19 years (range: 11–42 years). The graft diameter was 7.5 mm and the recipient bed diameter was 7.0 mm in all patients. The preoperative anterior chamber depth decreased from 3.92±0.47 mm to 3.01±0.55 mm (23% decrease). No significant postoperative change was observed in the mean iridocorneal angle values. Keratometric values decreased by 30% and corneal thickness increased by 50% (P<0.001 for both). Conclusion: Anterior chamber depth decreased significantly, but no change was observed in iridocorneal angle after penetrating keratoplasty in patients with keratoconus. Also, a decrease in the keratometric values and an increase in corneal thickness were observed. Understanding, estimating, and managing changes in the anterior chamber after penetrating keratoplasty, which induces significant changes in anterior chamber morphology, might increase the success of surgery.

[1]  A. Cerviño,et al.  Evaluation of the anterior chamber angle in keratoconus and normal subjects. , 2015, Contact lens & anterior eye : the journal of the British Contact Lens Association.

[2]  M. Rajabi,et al.  Comparison of corneal measurements in keratoconic eyes using rotating Scheimpflug camera and scanning-slit topography. , 2015, International journal of ophthalmology.

[3]  J. Durán,et al.  Optical Coherence Tomography Findings in Recurrent Corneal Erosion Syndrome , 2015, Cornea.

[4]  B. Li,et al.  Efficacy and Safety of Deep Anterior Lamellar Keratoplasty vs. Penetrating Keratoplasty for Keratoconus: A Meta-Analysis , 2015, PloS one.

[5]  C. Jayadev,et al.  Current review and a simplified “five-point management algorithm” for keratoconus , 2015, Indian journal of ophthalmology.

[6]  P. Asbell,et al.  Progression in Keratoconus and the Effect of Corneal Cross-Linking on Progression , 2014, Eye & contact lens.

[7]  Yasin Cinar,et al.  Comparison of accelerated and conventional corneal collagen cross-linking for progressive keratoconus , 2014, Cutaneous and ocular toxicology.

[8]  Yasin Cinar,et al.  Accelerated corneal collagen cross-linking for progressive keratoconus , 2014, Cutaneous and ocular toxicology.

[9]  N. Mohidin,et al.  Anterior segment characteristics of keratoconus eyes in a sample of Asian population. , 2013, Contact lens & anterior eye : the journal of the British Contact Lens Association.

[10]  J. Alió,et al.  Intrasubject repeatability in keratoconus‐eye measurements obtained with a new Scheimpflug photography–based system , 2013, Journal of cataract and refractive surgery.

[11]  T. Mimura,et al.  Extended Long-Term Results of Penetrating Keratoplasty for Keratoconus , 2010, Cornea.

[12]  S. Yoloğlu,et al.  Evaluation of anterior segment parameters in keratoconic eyes measured with the Pentacam system , 2007, Journal of cataract and refractive surgery.

[13]  S. Pieh,et al.  Changes of axial length and keratometry after keratoplasty for keratoconus using the guided trephine system. , 2002, American journal of ophthalmology.

[14]  J. Krumeich,et al.  Live‐epikeratophakia for keratoconus , 1998, Journal of cataract and refractive surgery.

[15]  K. Buzard,et al.  Corneal transplant for keratoconus: Results in early and late disease , 1997, Journal of cataract and refractive surgery.

[16]  M. Javadi,et al.  A Comparison Between Donor-Recipient Corneal Size and Its Effect on the Ultimate Refractive Error Induced in Keratoconus , 1993, Cornea.

[17]  S. Mishima Corneal thickness. , 1968, Survey of ophthalmology.