Permanen Corneal Ring in Penetrating Keratoplasty

¹Krumeich J. H., ²Duncker G. I. W., ³Uthoff D.,
¹Martin-Luther-Krankenhaus, Augenabteilung (Bochum)
²Martin-Luther-Universität, Klinik und Poliklinik für Augenheilkunde (Halle/Saale)
³Augenklinik Kiel-Bellevue (Kiel)

Purpose: Stabilization of postoperative refraction. Transducing vectors on the ring should allow better wound adaptation and button protection in particular in peripherally vascularized corneas or triple procedures.
Method: A 15/100 mm (±1/100) x 7,95/8,10 mm ring made of Cobalt/Titanium/ Molybdenum alloy was sutured into PKP wound. 110 consecutive cases (GR I) with a minimum follow-up of 1 year were compared to an identical control group without ring (GR II).
Results: Postop cylinder was – 2,5 D (GR I) to 2.9 D (GR II). BCVA was 0.45 after 6 months and 0.6 after one year in both groups. In GR I sphere and cylinder remained the same whereas all values including axes changed in GR II. Endothelial cellcounts after one year were 1780 cells/qmm in GR I versus 1650 cells /qmm in Gr. II. Ingrowing vessels deviated frequently at ring level. Sutures if pulling through could be removed in ring cases 4 months postoperatively with no visible disadvantage. There was one immune reaction after one year (0.9%) in group I compared to 7 (6,5%) in group II.
Conclusion: Corneal ring seems to accelerate healing, may reduce immune reaction, and may act as a barrier to vessels. Astigmatism or postoperative visual acuity seem little influenced. Refraction in the postop course is more stable in the ring group. Endothelial cell count was statistically not significantly different after one year.

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