Penetrating keratoplasty combined with vitreoretinal surgery for severe ocular injury with blood-stained cornea and no light perception

Ophthalmologica. 2006;220(3):186-9. doi: 10.1159/000091763.

Abstract

Objective: To evaluate the effects of treatment of severe ocular injury with blood-stained cornea and no light perception by combined penetrating keratoplasty and vitreoretinal surgery, and to analyze the relevant factors.

Methods: Records of 7 severely injured eyes of 7 patients with blood-stained cornea and no light perception who underwent penetrating keratoplasty combined with vitrectomy using a temporary keratoprosthesis were evaluated retrospectively. The preoperative visual acuity was no light perception in all injured eyes with a mean intraocular pressure of 3 mm Hg and a range from 2 to 5 mm Hg. The average interval from emergency wound closure to vitrectomy was 18 days with a range from 12 to 21 days. The mean follow-up was 28 months with a range from 26 to 30 months.

Results: The postoperative visual acuity was better than light perception in 5 eyes with the best corrected visual acuity from light perception to 0.06. The retina was attached in 5 eyes. The postoperative intraocular pressure ranged from 5 to 15 mm Hg with a mean of 12 mm Hg; it was significantly higher than the preoperative one (p < 0.05). The postoperative complications mainly included temporary intraocular elevation (1 eye), corneal neovascularization (4 eyes), corneal rejection (4 eyes), retinal detachment (2 eyes) and ocular atrophy (2 eyes).

Conclusion: Penetrating keratoplasty combined with vitrectomy using a temporary keratoprosthesis is a safe and effective method in treating severe ocular injury with blood-stained cornea and no light perception.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Cornea / pathology
  • Cornea / surgery
  • Corneal Injuries*
  • Eye Injuries / diagnosis
  • Eye Injuries / physiopathology
  • Eye Injuries / surgery*
  • Follow-Up Studies
  • Humans
  • Keratoplasty, Penetrating / methods*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Trauma Severity Indices
  • Treatment Outcome
  • Visual Acuity*
  • Vitrectomy / methods*