Abstract
P 033
Keratoplasty according to Putschkowskaya (Putschkowskaya keratoplasty) as surgical alternative in postoperative wound healing dysfunction after perforating keratoplasty.
Melanie Meth, Hans-Gerd Struck, Gernot Duncker, Claudia Grünauer-Kloevekorn
Universitätsklinik und Poliklinik für Augenheilkunde, Martin-Luther-Universität Halle-Wittenberg, Halle/Saale
Objective
Wound healing dysfunction causing to several early and late complications have been described since the introduction of keratoplasty. Postoperative complications of the corneal surface are ranging from therapy resistant superficial corneal erosion up to perforation of corneal donor due to corneal ulcer. Using amniotic membrane patch seems to be therapy option of choice. Nevertheless in some severe cases even this technique does not lead to satisfactory results. We report on surgical treatment in 3 cases of therapy resistant corneal surface complications following penetrating keratoplasty.
Methods
In three patients (2 female, 1 male) aged between 70 and 81 years with therapy resistant complications of corneal surface following keratoplasty amnion membrane patch surgery was performed using different techniques (inlay, onlay, cross-linking, non-cross-linking). Due to unsatisfactory wound healing the patients have been provided with a Putschkowskaya keratoplasty.
Results
In 2 patients we found a complete re-epithelization of the corneal graft after removing the Putschkowskaya keratoplasty. The third patient showed a colliquation of the Putschkowskaya keratoplasty within 31 days. After a reapplication of the Putschkowskaya keratoplasty a complete re-epithelization of the corneal graft took place.
Conclusions
In severe cases of wound healing dysfunction on the corneal surface following penetrating keratoplasty which cannot treat with amniotic membrane patch sufficiently a Putschkowskaya keratoplasty seems to be one option to prevent these cases primary from further penetrating keratoplasty. Further keratoplasty especially in HLA matched manner can be performed in stable corneal situation to improve visual acuity.
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