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Abstract
Abstract
Ipsilateral Autologous Keratoplasty: a Safe Access for Lens Surgery in Extreme Microcornea
Gronemeyer A., Seitz B., Naumann G. O. H.
Department of Ophthalmology, University of Erlangen-Nürnberg, Erlangen, Germany
Purpose: In spite of modern microsurgical techniques and phacoemulsification, cataract surgery in extreme microcornea is afflicted with the risk of corneal endothelial damage.
Method: Between 1987 and 2003 six patients (7 eyes) with microcornea (corneal diameter 6.5-10 mm) were operated using ipsilateral autologous keratoplasty as access for cataract surgery. Further diagnoses were: coloboma of the iris, retina, choroid and optic nerve, staphyloma posticum, korectopia, congenital cataract, nystagm and amblyopia. One patient had an "optical" microcornea after several keratoplasties following chemical injury. She had received the last HLA-typed keratoplasty two years before cataract surgery via ipsilateral keratoplasty was performed. Patient age ranged between 35 and 68 years at the time of surgery. Preoperative evaluation included visual acuity, intraocular tension, endothelial cell density, lens shape (ultrasound), and if necessary retinal function (ERG). Intracapsular cataract extraction (2 eyes) or extracapsular cataract extraction (5 eyes) was performed via a 6.0 to 7.5 mm mechanical corneal trephination. In 4 eyes a posterior chamber lens was implanted. The ipsilateral autologous non rotated corneal button was reimplanted either by single sutures or two continous sutures. If necessary suturing of the iris was performed. Follow-up period was 3 months to 10 years