Combined penetrating keratoplasty and keratolimbal allograft transplantation in comparison with corneoscleral transplantation in the treatment of severe eye burns

Abstract

The aim of this study is to compare the therapeutic outcomes between penetrating keratoplasty (PK) combined with keratolimbal allograft (KLAL) transplantation and corneoscleral transplantation in patients with severe corneal burns. Thirty-eight patients (39 eyes) diagnosed severe corneal burns in stable status with vascularization and corneal opacity were included. We performed combined PK with KLAL transplantation in 23 eyes (group A) and corneoscleral transplantation in 16 eyes (group B). The main outcome measures were postoperative complications and long-term visual acuity and rejection. The incidence of postoperative complications (corneal epithelium defect, hyphaema and hypotony) in group A were obviously less than those in group B. Fifteen eyes (65%) in group A and four eyes (25%) in group B had best-corrected visual acuity of >0.05 at 24 months (P = 0.022). Limbal stem cell rejection occurred in eleven grafts (48%) in group A and eight grafts (50%) in group B (P = 1.000). Nine grafts (39%) in group A and 12 grafts (54%) in group B had endothelial rejection (P = 0.049). PK combined with KLAL transplantation may reduce the risk of postoperative complications. Long-term prognosis appears better than corneoscleral transplantation in the treatment of severe eye burns.