Abstract

P 012

Penetrating keratoplasty with corneal ring – long-term results of a prospective randomized study

Florian Birnbaum, Johannes Schwartzkopff, Thomas Reinhard

Universitäts-Augenklinik Freiburg

Background and purpose
The purpose of the study was to evaluate the efficacy and safety of a corneal ring (Krumeich) following penetrating keratoplasty. Primary endpoint was postoperative astigmatism. In the long term evaluation all patients were examined following complete suture removal.
Methods
20 patients were included in this study (10 patients with keratoconus, 10 patients with Fuchs endothelial dystrophy). After randomization 10 patients received a corneal ring and in 10 patients penetrating keratoplasty was carried out without corneal ring. Follow-up examinations were performed 6 weeks, 4, 12, and 18 months postoperatively and after complete suture removal and included best corrected visual acuity and Orbscan corneal topography.
Results
Mean follow up time is 2.4 years. The mean astigmatism is 4.1 diopters in the ring-group and 4.6 diopters in the group without ring (p=0.38). One patient had to be excluded from the study due to suture rupture and damaging of the ring following an injury. In 4 patients with corneal ring spontaneous suture rupture occurred, in 2 patients resuturing was necessary. Two patients of the ring group had an immune reaction and none of the control group patients (p=0.14). Mean annual endothelial cell loss is 16.1% n the ring group and 9.2% in the control group (p=0.13).
Conclusions
The use of the corneal ring following penetrating keratoplasty showed no statistically significant reduction of astigmatism after complete suture removal. Regarding the appearance of immune reactions and the annual endothelial cell loss no statistically significant differences were observed.

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