Abstract
AbstractPurposeCongenital aniridia is a challenge not only for the corneal surgeon. Persisting epithelial defects, suture loosening, and an increased risk of graft rejection are typical postoperative complications in high risk keratoplasty such as in congenital aniridia.MethodsBetween 2012 and 2018, 20 keratoplasties were performed in 13 patients with congenital aniridia at our Department. Visual acuity and intraocular pressure before and after keratoplasty, corneal graft size, suture technique (interrupted or double running), use of amniotic membrane transplantation and serum eye drops, size of bandage contact lens as well as morphological and functional status during follow‐up were analysed retrospectively.ResultsSix keratoplasties were performed using continuous double running suture, 14 using interrupted sutures. Amnion membrane transplantation as a patch with a 17 mm bandage contact lens was applied 18 times to promote postoperative corneal wound healing. In 10 cases, a simultaneous temporary lateral tarsorrhaphy was performed to support corneal wound closure. All patients received systemic immunosuppression. Visual acuity improved in 14 eyes at 6 months follow‐up, in 6 eyes visual acuity remained stable, no eye showed a decrease in visual acuity.ConclusionsKeratoplasty in congenital aniridia must be considered a high risk keratoplasty. A modified keratoplasty scheme combining a small corneal graft size, interrupted sutures, simultaneous AMT Patch, large bandage contact lens, temporary lateral tarsorrhaphy, postoperative autologous serum eye drops, and systemic immunosuppression seems to be appropriate to reduce the postoperative complication rate in these most difficult eyes.
Published Version
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