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*

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

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

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*

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*

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