Indications and Results of Emergency Penetrating Keratoplasty With Simultaneous Cataract Surgery ("Triple-PKP à Chaud").
Journal
Cornea
ISSN: 1536-4798
Titre abrégé: Cornea
Pays: United States
ID NLM: 8216186
Informations de publication
Date de publication:
01 Mar 2023
01 Mar 2023
Historique:
received:
30
11
2021
accepted:
17
02
2022
pubmed:
20
5
2022
medline:
14
2
2023
entrez:
19
5
2022
Statut:
ppublish
Résumé
The purpose of this study was to analyze the indications and clinical results of emergency penetrating keratoplasty with simultaneous cataract surgery ("Triple-PKP à chaud"). This study included all subjects who underwent Triple-PKP à chaud between 2006 and 2020 at the Department of Ophthalmology, Saarland University Medical Center, Homburg/Saar in Germany. Data obtained from patient records were retrospectively analyzed. Triple-PKP à chaud was successfully performed in 27 of 29 eyes with a mean age of 66.0 ± 19.9 years. Previous surgery was performed in 20 eyes (69.0%), most frequently amniotic membrane transplantation in 11 eyes (37.9%) and previous keratoplasty in 9 eyes (31.0%). The most common indication was infectious keratitis (62.1%). In 27 subjects (93.1%), capsulorhexis was performed using the open-sky technique. The most frequent intraoperative complication was positive vitreous pressure (24.1%). In 2 eyes (6.9%), no intraocular lens implantation was performed because of posterior capsule rupture. The preoperative uncorrected visual acuity improved from 2.2 ± 0.6 logMAR (range = 3.0-0.7 logMAR) to 1.3 ± 0.7 logMAR (range = 3.0-0.18 logMAR) postoperatively ( P < 0.001). Common postoperative complications were suture loosening (44.4%) and corneal epithelial defects (33.3%). Repeat keratoplasty was necessary in 14 eyes (51.9%), including 9 eyes (64.2%) within 12 months postoperatively. The mean graft survival was 12.2 ± 17.9 months (range = 1-69 mo). Triple-PKP is also feasible in emergency conditions. Nevertheless, the surgery is associated with an increased risk of intraoperative and postoperative complications. Combined surgery should, therefore, only be performed in severely diseased eyes with progressed stage of cataract.
Identifiants
pubmed: 35587899
doi: 10.1097/ICO.0000000000003035
pii: 00003226-202303000-00002
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
272-279Informations de copyright
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
The authors have no funding or conflicts of interest to disclose.
Références
Taylor DM. Keratoplasty and intraocular lenses. Ophthalmic Surg. 1976;7 1:31–42.
Seitz B, Langenbucher A, Viestenz A, et al. Cataract and keratoplasty–simultaneous or sequential surgery? [in German]. Klin Monbl Augenheilkd. 2003;220:326–329.
Seitz B, Asi F, Mäurer S, et al. Anterior segment OCT: application to improve graft selection for corneal transplantation. In: Atlas of Anterior Segment Optical Coherence Tomography. Berlin, Germany: Springer; 2021:223–236.
Hamon L, Daas L, Mäurer S, et al. Thickness and curvature changes of human corneal grafts in dextran-containing organ culture medium before keratoplasty. Cornea. 2021;40:733–740.
Wykrota AA, Weinstein I, Hamon L, et al. Approval rates for corneal donation and the origin of donor tissue for transplantation at a university-based tertiary referral center with corneal subspecialization hosting a LIONS Eye Bank. BMC Ophthalmol. 2022;22:17.
Das S, Langenbucher A, Jacobi C, et al. Long-term refractive and visual outcome after penetrating keratoplasty only versus the triple procedure in Fuchs' dystrophy. Graefes Arch Clin Exp Ophthalmol. 2006;244:1089–1095.
Seitz B, Langenbucher A, Kus MM, et al. Nonmechanical corneal trephination with the excimer laser improves outcome after penetrating keratoplasty. Ophthalmology. 1999;106:1156–1165.
Seitz B, Das S, Sauer R, et al. Simultaneous amniotic membrane patch in high-risk keratoplasty. Cornea. 2011;30:269–272.
Seitz B, Grüterich M, Cursiefen C, et al. Conservative and surgical treatment of neurotrophic keratopathy [in German]. Ophthalmologe. 2005;102:15–26.
Trinh T, Mimouni M, Santaella G, et al. Surgical management of the ocular surface in neurotrophic keratopathy: amniotic membrane, conjunctival grafts, lid surgery, and neurotization. Eye Contact Lens. 2021;47:149–153.
Koay PY, Lee WH, Figueiredo FC. Opinions on risk factors and management of corneal graft rejection in the United Kingdom. Cornea. 2005;24:292–296.
Cobo LM, Coster DJ, Rice NS, et al. Prognosis and management of corneal transplantation for herpetic keratitis. Arch Ophthalmol. 1980;98:1755–1759.
Jabbehdari S, Rafii AB, Yazdanpanah G, et al. Update on the management of high-risk penetrating keratoplasty. Curr Ophthalmol Rep. 2017;5:38–48.
Maguire MG, Stark WJ, Gottsch JD, et al. Risk factors for corneal graft failure and rejection in the collaborative corneal transplantation studies. Ophthalmology. 1994;101:1536–1547.
Coster DJ, Williams KA. Management of high-risk corneal grafts. Eye (Lond). 2003;17:996–1002.
Cruzat A, Witkin D, Baniasadi N, et al. Inflammation and the nervous system: the connection in the cornea in patients with infectious keratitis. Invest Ophthalmol Vis Sci. 2011;52:5136–5143.
Zwingelberg SB, Bachmann BO, Cursiefen C. Real life data on efficacy and safety of topical NGF eye drops. Klin Monbl Augenheilkd. 2020;237:1455–1461.
Wang AL, Weinlander E, Metcalf BM, et al. Use of topical insulin to treat refractory neurotrophic corneal ulcers. Cornea. 2017;36:1426–1428.
Soares RJDSM, Arêde C, Sousa Neves F, et al. Topical insulin–utility and results in refractory neurotrophic keratopathy in stages 2 and 3. Cornea. 2021 [epub ahead of print].
Ferguson AW, Scott JA, McGavigan J, et al. Comparison of 5% povidone-iodine solution against 1% povidone-iodine solution in preoperative cataract surgery antisepsis: a prospective randomised double blind study. Br J Ophthalmol. 2003;87:163–167.
Zhang Q, Zhao M, Xu M, et al. Outcomes of therapeutic keratoplasty for severe infectious keratitis in Chongqing, a 16-year experience. Infect Drug Resist. 2019;12:2487–2493.
Kirkness CM, Ficker LA, Steele AD, et al. The role of penetrating keratoplasty in the management of microbial keratitis. Eye (Lond). 1991;5(pt 4):425–431.
Laurik KL, Szentmáry N, Daas L, et al. Early penetrating keratoplasty À chaud may improve outcome in therapy-resistant acanthamoeba keratitis. Adv Ther. 2019;36:2528–2540.
Alfaro Rangel R, Lepper S, Szentmáry N, et al. Herpes simplex virus keratitis in a University Tertiary Referral Centre–clinical features and surgical approaches. Klin Monbl Augenheilkd. 2021;238:989–995.
Alfaro Rangel R, Szentmáry N, Lepper S, et al. Large-diameter penetrating keratoplasties are mostly due to very severe infectious keratitis and cannot always prevent secondary enucleation. Klin Monbl Augenheilkd. 2021:6–13.
Schrecker J, Seitz B, Berger T, et al. Malignant keratitis caused by a highly-resistant strain of Fusarium tonkinense from the Fusarium solani complex. J Fungi. 2021;7:1093.
Birnbaum F, Böhringer D, Sokolovska Y, et al. Immunosuppression with cyclosporine A and mycophenolate mofetil after penetrating high-risk keratoplasty: a retrospective study. Transplantation. 2005;79:964–968.
Reinhard T, Sundmacher R, Heering P. Systemic ciclosporin A in high-risk keratoplasties. Graefes Arch Clin Exp Ophthalmol. 1996;234(suppl 1):S115–S121.
Mayer K, Reinhard T, Reis A, et al. Synergistic antiherpetic effect of acyclovir and mycophenolate mofetil following keratoplasty in patients with herpetic eye disease: first results of a randomised pilot study. Graefes Arch Clin Exp Ophthalmol. 2003;241:1051–1054.
Culbertson WW, Abbott RL, Forster RK. Endothelial cell loss in penetrating keratoplasty. Ophthalmology. 1982;89:600–604.
Acar BT, Buttanri IB, Sevim MS, et al. Corneal endothelial cell loss in post-penetrating keratoplasty patients after cataract surgery: phacoemulsification versus planned extracapsular cataract extraction. J Cataract Refract Surg. 2011;37:1512–1516.
Kim EC, Kim MS. A comparison of endothelial cell loss after phacoemulsification in penetrating keratoplasty patients and normal patients. Cornea. 2010;29:510–515.
Özkiriş A, Arslan O, Cicik E, et al. Open-sky capsulorrhexis in triple procedure: with or without trypan blue? Eur J Ophthalmol. 2003;13:764–769.
Shimomura Y, Hosotani H, Kiritoshi A, et al. Core vitrectomy preceding triple corneal procedure in patients at high risk for increased posterior chamber pressure. Jpn J Ophthalmol. 1997;41:251–254.
Vongthongsri A, Jakpaiwong W, Preechanon A, et al. Anterior vitreous tapping to manage positive vitreous pressure during triple procedures. Ophthalmology. 2005;112:875–878.
Chronopoulos A, Thumann G, Schutz J. Positive vitreous pressure: pathophysiology, complications, prevention, and management. Surv Ophthalmol. 2017;62:127–133.
Sridhar MS, Murthy S, Bansal AK, et al. Corneal triple procedure: indications, complications, and outcomes: a developing country scenario. Cornea. 2000;19:333–335.
Fiorentzis M, Morinello E, Viestenz A, et al. Muscle relaxants as a risk factor for vis-à-tergo during penetrating keratoplasty: a prospective interventional study. Adv Ther. 2017;34:2674–2679.
Zuche H, Morinello E, Viestenz A, et al. The effect of non-depolarising muscle relaxants on ocular pulse amplitude and intraocular pressure [in German]. Klin Monbl Augenheilkd. 2015;232:1397–1401.
Groh M, Seitz B, Händel A, et al. Expulsive hemorrhage in penetrating keratoplasty–incidence and risk factors [in German]. Klin Monbl Augenheilkd. 1999;215:152–157.
Bachmann B, Taylor RS, Cursiefen C. Corneal neovascularization as a risk factor for graft failure and rejection after keratoplasty: an evidence-based meta-analysis. Ophthalmology. 2010;117:1300–1305.e7.
Panda A, Jaffery NF, Sony P, et al. Immunologic graft reaction after allogenic penetrating keratoplasty. Am J Ophthalmol. 2002;134:793–794.
Wan S, Cheng J, Dong Y, et al. Epithelial defects after penetrating keratoplasty in infectious keratitis: an analysis of characteristics and risk factors. PLoS One. 2018;13:e0208163.
Wirostko B, Rafii M, Sullivan DA, et al. Novel therapy to treat corneal epithelial defects. A hypothesis Growth Horm. 2016;13:204–212.e1.
Dana MR, Goren MB, Gomes JA, et al. Suture erosion after penetrating keratoplasty. Cornea. 1995;14:243–248.
Zambelli AM, Brothers KM, Hunt KM, et al. Diffusion of antimicrobials across silicone hydrogel contact lenses. Eye Contact Lens. 2015;41:277–280.
Zhu B, Liu Y, Lin L, et al. Characteristics of infectious keratitis in bandage contact lens wear patients. Eye Contact Lens. 2019;45:356–359.