PURPOSE:To analyze the clinical results of Goldmann applanation tonometry (GAT) and Pascal dynamic contour tonometry (PDCT) and the influences of central corneal thickness and keratometric power in eyes that underwent EpiLASIK or penetrating keratoplasty. METHODS: Measurements of intraocular pressure by GAT and PDCT as well as keratometric power and central corneal thickness were measured in 45 eyes that underwent penetrating keratopasty and 63 eyes that underwent EpiLASIK. These parameters were also measured in healthy eyes with no specific disorders to create a control group. RESULTS: In the keratoplasty group, the PDCT results were significantly higher than the GAT results by 1.22+/-2.84 mmHg (p=0.006), but neither method showed a significant correlation with CCT or keratometric power. In the EpiLASIK group, PDCT was higher as 3.45+/-2.35 mmHg than GAT, and the corrected results of GAT were not different from the results of PDCT. In the control group, GAT was affected by central corneal thickness and keratometric power, but PDCT showed no significant relationship with these two factors. CONCLUSIONS: After EpiLASIK or penetrating keratoplasty, both of which change CCT and keratometric power, IOP cannot be accurately measured by GAT. In these patients, PDCT may play an important clinical role since it is less affected by corneal properties.
Corneal Transplantation ; Eye ; Humans ; Intraocular Pressure ; Keratoplasty, Penetrating ; Manometry ; Peptides

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

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

PURPOSE: To compare the accuracy and reproducibility of central corneal thickness measured by non-contact specular microscopy, ultrasound pachymetry, and Orbscan in the post-penetrating keratoplasty eyes. METHODS: Central corneal thickness was prospectively measured in eyes that had recieved penetrating keratoplasty at least 1 month before. One experienced technician measured all eyes using three methods; non-contact specular microscopy (Topcon SP-2000P; Topcon Corporation, Tokyo, Japan), Orbscan IIz (Orbtek; Bausch & Lomb, Rochester, USA), and ultrasound pachymetry (AL-2000; Tomey, Erlangen, Germany). Three consecutive measurements were performed using each method and the mean values and coefficient of variation were compared. RESULTS: The mean values of central corneal thickness were 550.7+/-63.3 micrometer with specular microscopy, 548.2+/-72.5 micrometer with ultrasound pachymetry, and 472.5+/-151.7 micrometer with Orbscan. There was no significant difference between the measurements obtained by specular microscopy and ultrasound pachymetry (p=0.53), and both methods showed high reproducibility. The corneal thickness measured by Orbscan was remarkably variable and in some patients, Orbscan was unable to measure corneal thickness. CONCLUSIONS: Non-contact specular microscopy appears to be an effective technique, potentially replacing ultrasound pachymetry for measuring central corneal thickness in the post-penetrating keratoplasty eyes.
Corneal Transplantation ; Humans ; Keratoplasty, Penetrating ; Microscopy ; Prospective Studies ; Ultrasonography

PURPOSE: To evaluate the current status of pathological report in the accurate diagnosis of recipient cornea following penetrating keratoplasty. METHODS: We performed a chart review of the hospital records of 174 patients (191 eyes) who had received keratoplasty in between January, 1994 and March, 2002. RESULTS: Pathologists described pathological diagnoses in 64 cases (33.5%). Pathological diagnosis seemed to be made according to patients' clinical diagnosis. Pathologists described the same disease in various forms. Special staining was used in 9 cases (4.71%). CONCLUSIONS: In most cases, pathologists described pathological findings without a definite diagnosis. We suggest a new form of pathological report for better description of corneal disease. There should be a system for active interchange between ophthalmologists and pathologists.
Cornea ; Corneal Diseases ; Corneal Transplantation ; Diagnosis* ; Hospital Records ; Humans ; Keratoplasty, Penetrating* ; Pathology

PURPOSE: To evaluate the risk factors for cataract formation and cataract extraction after penetrating keratoplasty to determine whether a combined surgery should be performed. METHODS: Variables from 189 phakic eyes that underwent penetrating keratoplasty from April 1992 to November 2004 were analyzed for the possibility of cataract extraction after penetrating keratoplasty according to sex, age, diagnosis, accompanied glaucoma, preoperative vision and steroid use. The mean interval between penetrating keratoplasty and cataract extraction was also studied. RESULTS: Cataract extraction was performed in 27 eyes (14.3%) and the mean interval between keratoplasty and cataract extraction was 24.5 months. Age was determined to be the most important independent risk factor for cataract extraction (p=0.0009) associated glaucoma also shown to be a risk factor (p=0.0011). Sex and corneal disease before keratoplasty were not shown to be risk factors. In the mean interval cataract extraction following penetrating keratoplasty, no statistically significant difference was found according to age, sex and diagnosis. Posterior subcapsular cataract was predominant (55.6%) and the mean visual acuity improved from 0.10 to 0.42. CONCLUSIONS: The likelihood of cataract formation and cataract extraction subsequent to penetrating keratoplasty increased with age and associated glaucoma. The results from this study can help surgeons to determine whether combined surgery should be performed and help them to counsel patients on the risk of cataract formation.
Cataract Extraction ; Cataract* ; Corneal Diseases ; Corneal Transplantation ; Diagnosis ; Glaucoma ; Humans ; Keratoplasty, Penetrating* ; Risk Factors ; Visual Acuity

The functional restoration of the corneal endothelium is vital to the success of penetrating keratoplasty and essential in maintaining corneal clarity. The corneal thickness is the important prognostic factors for penetrating keratoplasty and evaluated with pachymetry. We studied the serial corneal thickness change after penetrating keratoplasty to evaluate the integrity of the corneal endotehlium and to determine the prognostic value. We found the Pearsons coorelation coefficient and evaluate the effect of following parameters with such as donor age, donror cornea status, enucleation time, corneal storage time, preoperative diagnosis, operation methods, lens status and post operative course on the changes of corneal thickness. The central corneal thickness was measured in 41 eye and averaged 0.716 mm. in the post operative 1 day. Average central corneal thickness progressively decreased following penetrating keratoplasty and reached the stabilization of corneal thikckness at the postoperative 30 days with 0.537mm. Factors influencing on the corneal thickness are lens status, combined procedure with keratoplasty, longer enucleation time, complications during the follow-up course.
Cornea ; Corneal Transplantation ; Diagnosis ; Endothelium, Corneal ; Follow-Up Studies ; Humans ; Keratoplasty, Penetrating* ; Tissue Donors

Penetrating keratoplasty with or without intraocular lens implantation is necessary to restore a vision of an eye with aphakic bullous keratopathy. We analyzed surgical outcomes in eleven aphakic bullous keratopathy patients(11, eyes) who received penetrat-ing keratoplasty with scleral-fixated posterior chamber lens(PCL)at Kangnam St.Mary's hospital from January, 1989 to December 1991 and followed up more than 1 year Eight of eleven eyes showed the postoperative corrected VlSlOn of 0.3 to 0.8 at postoperative one year. The cuases of poor vision below 0.3 were age-related macular degeneration(1 eye), graft failure(I eye) and diabetic retinopathy(1 eye). At one year after surgery, mean spherical equivalent was-1.12, mean astigmatism was 4.21D and percent loss of corneal endothelium was 35.5%. Graft rejection(3 eyes) and secondary glaucoma(1 eye) were occured during the postoplasty with scleral-fixated PCL can be an excellent surgical technique to get visual rehabilitaion of patients with an aphakic bullous keratopathy.
Astigmatism ; Corneal Transplantation ; Endothelium, Corneal ; Humans ; Keratoplasty, Penetrating* ; Lens Implantation, Intraocular ; Transplants

To know the difference in graft rejection after corneal transplantation between moist chamber and Optisol(Chiron Co. Irvine, CA, U.S.A.) as cornea preservation methods, we compared two groups involving 50 patients(71 eyes) who had undergone partially penetrating keratoplasty (PPKP) for the treatment of keratoconus or corneal dystrophy from 1991 to 1995. The graft rejection had occurred in 10 of 40 eyes(25%) in moist chamber group and 9 of 31 eyes(29%) in Optisol group, and the cases of permanent corneal opacity after rejection were 5 of 40 eyes(12.5%), 3 of 31 eyes(9.7%) respectively. No difference in the two groups was statistically significant(P<0.05). We found the fact that the difference did not exist in the results from graft rejection after PPKP using moist chamber method for short preservation period, or Optisol method for the relatively long period allowing serological and immunological screen test.
Cornea ; Corneal Opacity ; Corneal Transplantation ; Graft Rejection* ; Keratoconus ; Keratoplasty, Penetrating ; Transplants*

PURPOSE: Although the treatment of choice for bullous keratopathy is typically penetrating keratoplasty (PKP), not all patients are suited for this treatment. Thus, we evaluated the clinical effects of phototherapeutic keratectomy (PTK) on pain relief and on the improvement of photophobia and visual acuity in patients suffering from bullous keratopathy. METHODS: Twenty-three patients with bullous keratopathy who were awaiting PKP and suffering from ocular pain, photophobia, and cosmetic problems, were assessed. Twelve eyes were treated with PTK using the excimer laser (VISX STAR S3, Irvine, CA, U.S.A). Another 11 eyes were treated with eye drops or other conservative modalities. Statistically significant differences in pain relief, photophobia improvement, and cosmetic improvement between two groups were assessed by Fisher's exact test. RESULTS: Twelve eyes with bullous keratopathy underwent PTK. At post-operative 1 month, 83% of patients showed relief of pain, 75% of patients showed improvements in photophobia, and 58% of patients had increased visual acuity of one or more line. The overall satisfaction rate of PTK was 91%, but 67% of patients showed recurrence of corneal opacity and bullae formation at 6 months after the procedure. CONCLUSIONS: Phototherapeutic keratectomy (PTK) reduced pain and improved visual acuity slightly in patients with bullous keratopathy. This procedure could be considered a valuable alternative treatment modality while awaitng PKP.
Corneal Opacity ; Corneal Transplantation ; Humans ; Keratoplasty, Penetrating ; Lasers, Excimer ; Ophthalmic Solutions ; Photophobia ; Recurrence ; Visual Acuity