Spelsberg H., Reinhard T., Sundmacher R.

Eye Clinic, Heinrich-Heine-University, Moorenstr. 5, 40225 Düsseldorf

Purpose: Since six years homologeous penetrating central limbokeratoplasty (LKP) is performed in granular and lattice corneal dystrophy in order to avoid or minimize recurrences of the dystrophy in the corneal graft*. This procedure was tested for efficiency with a clinical follow-up of about six years.
Methods: Since mai 1995 14 eyes from 12 patients with lattice dystrophy and 15 eyes from 10 patients with granular dystrophy were treated with LKP. Postoperatively, systemic immunosuppressants like ciclosporin A (21 eyes) or mycophenolate mofetil (8 eyes) were administered for six months. All patients achieved longterm topical immune prophylaxis with two drops prednisolone-21-acetate 1% per day.
Results: With a mean follow-up of 28.1 months (3 - 68.4) three central recurrences exclusively in eyes with granular dystrophy were observed (3/16; 19%): Once topical immune prophylaxis was tapered off probably too early (recurrence after 35 months), the remaining two eyes showed avascular donor limbal tissue (recurrence after 43 and 55 months).
Conclusion: In comparison to conventional penetrating keratoplasty - 80% recurrences in granular and 16% recurrences in lattice corneal dystrophy after four years (Kaplan-Meier-estimation) - penetrating limbo-keratoplasty seems to be established in granular and lattice dystrophy. Sufficient vascularisation of the donor limbal tissue probably plays an important role. *Cornea 1999; 18(6): 664 - 670

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