No abstract available.
Keratoplasty, Penetrating*

A large amount of corneal astigmatism after penetrating keratoplasty is a common problem. The purpose of this study was to find out which is the best suture method to minimize the postoperative corneal astigmatism. Among 35 eyes there were 7 eyes in interrupted suture group, 14 eyes in continuous suture group, and 14 eyes in combined suture group. In order to minimize postoperative astigmatism selective suture removal was done in interrupted suture group or combined suture group, and suture tension adjustment was made in continuous suture group. At postoperative 20 months the mean astigmastism was 5.97D in interrupted suture group, 3.66D in continuous suture group and 2.87D in combined suture group, respectively. There was no statistical significance. In spite of statistical insignificance, the astigmatism of continuous or combined suture group after penetrating keratoplasty was smaller than that of interrupted suture group after penetrating keratoplasty.
Astigmatism* ; Keratoplasty, Penetrating* ; Sutures*

We performed suture tension adjustment (STA) in 8 patients who had undergone penetrating keratoplasty with 10-0 nylon running suture closure. 3 to 8 weeks after the surgery, STA was done by loosening the suture tension at the steep meridian and tightening at the flat meridian, guided by automatic keratometery, keratoscopic finding and manifest refraction. Pre-STA astigmatism of 6.27 +/- 1.84 diopter(D) was changed to 1.94 +/- 1.40D immediately after the adjustment. Post-STA astigmatism regressed mostly within two weeks of adjustment, remaining stable thereafter: In one case, suture breakage occurred during adjustment, and resuturing was done using a new 10-0 nylon tied to the broken ends without serious sequela.
Astigmatism ; Humans ; Keratoplasty, Penetrating* ; Nylons ; Running* ; Sutures*

PURPOSE: To describe femtosecond laser-assisted corneal biopsy and its use in assessing the causative organism in a case of fungal keratitis that occurred 8 months after penetrating keratoplasty. CASE SUMMARY: A 27-year-old man who had undergone penetrating keratoplasty 8 months prior showed atypical diffuse corneal haze and erosion. Diagnostic corneal biopsy using a femtosecond laser was performed because of repeated negative test results for an infectious organism and a lack of improvement, despite steroid and empirical antibiotic therapy. A corneal flap 200 micrometer in depth and 3 mm in diameter was obtained. The biopsy showed pseudohyphae, which led to a diagnosis of Candidal keratitis. No complications occurred during the procedure. CONCLUSIONS: Femtosecond laser-assisted corneal biopsy enabled identification of the infectious pathogen. This technique is easy, safe, and rapid, and it yields a biopsy specimen with a uniform depth and precise size. Femtosecond laser-assisted corneal biopsy can be used as an accurate diagnostic method in uncertain cases of corneal ulcers.
Adult ; Biopsy ; Humans ; Keratitis ; Keratoplasty, Penetrating

A new technique was proposed for the optical treatment of advanced cases of bullous keratopathy. Electrodiathermy (coagulation current of standard unit, 0.5-1 sec. small ball tip) on peripheral bullous area of recipient cornea, and then a partial penetrating keratoplasty(usually 6.0 ~ 7.0mm in diameter) on central bullous area of recipient corneas are main procedures. Young-donor corneas are used always, in fresh state. not exceeding 24 hours. Author performed this new technique on 8 eyes (6 patients; 2 patients on both eyes) of advanced bullous keratopathy. And among them 7 eyes (87.5%)showed successful crystal clear with improving useful vision, and only one eye(12.5%) showed opaque graft due to complicated glaucoma. Observation periodis, at least, from 12 months to 21 months.
Cornea ; Glaucoma ; Humans ; Keratoplasty, Penetrating* ; Transplants

PURPOSE: To study a refractive change after suture removal and to evaluate some factors for this change in penetrating keratoplasty. METHODS: We studied 53 eyes of 47 patients who had undergone penetrating keratoplasty. Subjective refraction and best corrected visual acuity were measured in all eyes before and after the removal of sutures. We also classified the subject eyes based on suture removal time, degree of astigmatism before suture removal, recipient trephine size and compared the change of astigmatism within the groups. RESULTS: Suture removal decreased the astigmatism by an average of 0.81 diopter (D) (p=0.02) and increased the best corrected visual acuity by an average of 0.17 (p=0.005). These results show that corneal astigmatism tends to decrease more with early suture removal (p=0.010), higher degree of astigmatism before suture removal (p<0.05) and smaller size of recipient trephine (p=0.014). CONCLUSIONS: The removal of entire suture after penetrating keratoplasty decreases corneal astigmatism. Furthermore, the outcome is influenced by suture removal time, degree of astigmatism before suture removal, and recipient trephine size.
Astigmatism* ; Humans ; Keratoplasty, Penetrating* ; Sutures* ; Visual Acuity

Combined penetrating keratoplasty, cataract extraction, and lens implantation is the currently accepted treatment of choice for patients with combined corneal and cataract diseases. However, surgeons have met some difficulties and disadvantages of "Open sky" extracapsular cataract extraction during the triple procedure because of open-system approach. Thus, author contrive "Quadri" procedure ; Combined Phototherapeutic Keratectomy, Penetrating Keratoplasty, Phacoemulsification and Posterior Chamber Lens Implantation, for closed-system approach, and performed successfully.
Cataract ; Cataract Extraction ; Humans ; Keratoplasty, Penetrating* ; Phacoemulsification*

Penetrating keratoplasty was performed in six eyes of granular corneal dystrophy. Vision was improved from worse than 0.05 to better than 0.4. Mean follow-up period is 14 months (12-18 months). Corneal deposits were stained for H and E. Masson trichrome, Wilder's reticulin and Luxol fast blue but not for PAS, Congo red and Oil red a stain. Electron micorscopic examination showed that polymorphic, electron dense rod-shaped bodies were present in the Bowman's layer and between stromal lamellae and in the interceliular space of corneal epithelium. And, for the first time we found a area looked like a transformation from normal stroma to the granular deposit.
Congo Red ; Epithelium, Corneal ; Follow-Up Studies ; Keratoplasty, Penetrating ; Reticulin

PURPOSE: To conform the effectiveness of Cyclosporin(CsA) in penetrating keratoplasty(PKP), we compared the survival rate of grafts between CsA-used group and CsA-unused group(control group) in high risk patients. MATERIAL AND METHOD: High risk cornea was defined as vascularization in 3 or 4 quadrants, recurrent graft or corneal surface disease. We reviewed the 74 eyes(74 patients) which received penetrating keratoplasty with high risk cornea, and compared the survival rate between CsA-used group and control group. RESULT: Twenty-nine of the 74 patients were treated with CsA(17 patients with topical CsA and 12 with oral CsA ). The survival rate of CsA-used group was not superior to that of control group. CONCLUSION: CsA seems not to be effective in graft survival of high risk PKP.
Cornea ; Cyclosporine* ; Graft Survival ; Humans ; Keratoplasty, Penetrating* ; Survival Rate ; Transplants

PURPOSE: This study was performed to evaluate the status of corneal transplantation in Korea over the last 6 years. METHODS: We evaluated the current status of domestic corneal transplantation using the data obtained from Korean Network for Organ Sharing (KONOS). We evaluated imported corneal transplantation by the number of corneal transplantations, the country of origin of imported cornea, the preserved state of corneas, the time from the death to transplantation and the result of corneal transplantation. The imported corneal transplantation data was obtained from the institution registered in KONOS and the institution recognized by the authers. RESULTS: The number of domestic cornea donations has not increased since 2000, but the number of transplantations using imported corneas has increased year by year. The quality of imported corneas was good. There was no difference in operation results when domestic corneas were used compared to the use of imported corneas from the USA, Australia or Sri Lanka. CONCLUSIONS: The increased use of imported corneas results of a deficiency in the number of domestic cornea donations. Social motivation should be used to increase domestic donations of corneas.
Australia ; Cornea ; Corneal Transplantation ; Keratoplasty, Penetrating* ; Korea ; Motivation ; Sri Lanka