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Functional Results after Autologous Rotating Keratoplasty: A Retrospective Analysis
Birnbaum F., Reinhard T., Ulbricht T., Haußer J., Sundmacher R.,
Heinrich-Heine-Universität Düsseldorf, Universitäts-Augenklinik (Düsseldorf)
Purpose: Autologous rotating keratoplasty is a therapeutic option in patients with central corneal scars. Its advantage in comparison with allogeneic procedures is the absence of immunological events. In this retrospective analysis long-term results are presented.
Patients: Since 1988 autologous rotating keratoplasty has been performed in 11 male and 8 female patients with a median age of 24 ± 19 years. Indications for surgery were corneal scars following herpes keratitis (6 patients), after penetrating injuries (6 patients), after bacterial ulcers (4 patients), in diseases of the eye-lids (2 patients) and after chemical burn (1 patient). Median follow up is 7.5 ± 4.4 years.
Results: In 16 of 19 patients the graft center has remained clear within the follow up. Reasons for central graft opacification were surface disorders in 2 patients with diseases of the eye-lids and in one patient recurrence of herpes keratitis. Visual acuity improved from 0.2 ± 0.13 (preoperative median) to 0.4 ± 0.25 with spectacles (postoperative median of all patients) and to 0.5 ± 0.25 with contact lenses (postoperative median of 11 patients with possible contact lens fitting). Median postoperative astigmatism was 4.0 ± 3.8 dpt with irregular components in 5 patients. Amblyopia (6 patients), glaucoma (2 patients), cataract (1 patient) and surface disorders (1 patient with atopic dermatitis) were at least in part responsible for limited visual acuity.
Conclusions: Only few postoperative graft complications were observed. The autologous grafts are not responsible for limited visual acuity in many patients. Especially in patients with an elevated risk for immune reactions (e.g. infants) autologous rotating keratoplasty is a safe alternative to allogenic procedures.