Pars plana vitrectomy combined with penetrating keratoplasty and transscleral-sutured intraocular lens implantation in complex eyes: a case series

BMC Ophthalmology

Toshiki Shimizu¹  Kentaro Yuda²  Tsubasa Kuroki³  Takahiko Hayashi⁴  Ida Yasutsugu⁵  Yasuhito Iijima⁶  Yuji Kobashigawa⁷ 

[1] Department of Ophthalmology, Yokohama City University School of Medicine, Yokohama, Kanagawa, Japan;Department of Ophthalmology, Yokohama City University School of Medicine, Yokohama, Kanagawa, Japan;Angiogenesis Laboratory, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, USA;Kikuna Yuda Eye Clinic, Yokohama, Kanagawa, Japan;Department of Ophthalmology, Yokohama Minami Kyosai Hospital, 1-21-1, Mutsuura Higashi, 236-0037, Yokohama, Kanagawa, Japan;Department of Ophthalmology, Yokohama Minami Kyosai Hospital, 1-21-1, Mutsuura Higashi, 236-0037, Yokohama, Kanagawa, Japan;Department of Ophthalmology, University of Cologne, Cologne, Germany;Department of Ophthalmology, Jichi Medical University, Tochigi, Shimotsuke, Japan;Department of Ophthalmology, Yokohama City University School of Medicine, Yokohama, Kanagawa, Japan;Department of Technology and Design Thinking for Medicine (DT2M), Hiroshima University, Hiroshima, Japan;Department of Ophthalmology, Yokohama Minami Kyosai Hospital, 1-21-1, Mutsuura Higashi, 236-0037, Yokohama, Kanagawa, Japan;Department of Ophthalmology, Yokohama City University School of Medicine, Yokohama, Kanagawa, Japan;Sofukai Oppama Ekimae Eye Clinic, Yokohama, Kanagawa, Japan;Yokosuka Chuo Eye Clinic, Yokohama, Kanagawa, Japan;

关键词: Penetrating keratoplasty;    Pars plana vitrectomy;    Intraocular lens implantation;    Transscleral-sutured intraocular lens;   

DOI  :  10.1186/s12886-020-01639-y

来源: Springer

【 摘 要 】

BackgroundThe aim of this study was to evaluate the clinical outcomes of pars plana vitrectomy (PPV) combined with penetrating keratoplasty (PKP) and transscleral-sutured intraocular lens (IOL) implantation (IOL-suture) in complex eyes.MethodsIn this prospective, consecutive interventional case series, patients who underwent PKP combined with PPV and IOL implantation from July 2014 to March 2018 at Yokohama Minami Kyosai Hospital were enrolled. The postoperative best corrected visual acuity (BCVA) (converted to logarithm of the minimal angle of resolution [logMAR] units), intraocular pressure (IOP, mmHg), endothelial cell density (ECD, cells/mm2), graft survival, complications, astigmatism, and spherical equivalent (dioptres [D]) were evaluated.ResultsThis study included 11 eyes of 11 patients (three females and eight males; mean age, 61.8 ± 13.9 years) with an injury (n = 6) or bullous keratopathy (n = 5). The BCVA significantly improved from 1.50 ± 0.66 logMAR preoperatively to 0.78 ± 0.59 logMAR (p < 0.001) postoperatively. The baseline ECD significantly decreased from 2396 ± 238 cells/mm2 preoperatively to 1132 ± 323 cells/mm2 (p < 0.001) postoperatively. Despite two rejection episodes, graft survival rates were 100%. The mean follow-up period was 38.0 ± 20.5 months. Two patients required combined glaucoma surgery, and three patients underwent subsequent glaucoma surgery. Postoperative astigmatism and spherical equivalent were 3.9 ± 3.2 D and 0.29 ± 2.18 D, respectively.ConclusionThe combination of PKP, PPV, and IOL-suture implantation could be a safe and effective approach for eyes requiring anterior segment surgery; however, these eyes are associated with a higher incidence of glaucoma surgery.

【 授权许可】

CC BY