Observation on the efficacy of keratoplasty combined with cataract and vitreoretinal surgery for severe ocular injuries

Abstract

Objective To observe the efficacy of keratoplasty combined with cataract and vitreoretinal surgery under temporary keratoprosthesis for the treatment of anterior and posterior segments severe ocular injuries. Methods The data of 18 eyes of 16 cases with anterior and posterior segments severe ocular injuries were collected and analyzed retrospectively. They received combined surgery under temporary keratoprosthesis.The etiology, operation indication, anterior and posterior segment functional restoration and complications were analyzed.The followed-up period was 10-48 months. Results The visual acuity after surgery were improved in 15 eyes(83.33%). Transparent grafts occurred in 8 eyes(44.44%)after operation.Corneal translucence occurred in 3 eyes(16.67%). The rejective corneal grafts of 7 eyes(38.89%) were cloudy and swelling. Among them, corneal grafts were not rejected after secondary corneal transplantation in 4 eyes.Four eyes(22.22%) with retinal detachment were followed up for retinal reposition, and they received silicone oil tamponade.Secondary glaucoma happened in 2 eyes (11.11%). Medicine conservative treatment was invalid. After trabeculectomy the normal intraocular pressure was controlled.No persistent low intraocular pressure was found. The eyeball structure integrity of 18 eyes were preserved. Conclusion Keratoplasty combined with cataract and vitreoretinal surgery under temporary keratoprosthesis for the treatment of anterior and posterior segments severe ocular injuries is effective. Key words: Ocular injury, severe; Keratoprosthesis, temporary; Keratoplasty, penetrating; Surgery, cataract; Surgery vitreoretinal