Rezumat. Scopul acestei lucrări este studierea eficacității keratoplastiei penetrante modificate în prevenirea complicațiilor chirurgiei
pe glob deschis. Acest tip de chirurgie este periculos pentru păstrarea postoperatorie a funcțiilor vizuale. Puchkovskaya N.A.
a propus o nouă metodă chirurgicală, fiind operați 165 de pacienți cu leucom cornean, afachie complicată, simblefaron etc.
Summary. To learn the efficacy of modified
penetrating keratoplasy (PK). In prevention of open
sky surgery in complicated patients. The open sky
surgery is very dangerous for the future functions
of the eye. This modification of PK allows us to
avoid open sky moment during operation and to
save the eye from the development of dangerous
complications of open sky eye surgery. According
to our experience, this technique may be used as
operation of choice in the microsurgical treatment
of complicated cases of corneal diseases.
Purpose. To learn the efficacy of modified
penetrating keratoplasy (PK)
In prevention of open sky surgery in complicated
patients.
Materials and methods. Our modification
of PR by Puchkovskaya N.A. included these main
steps: sequential and step-by-step cutting out and fixation of host and donor flap, slippery removing
of host flap using visco-protection of donor endothelium
cells, final fixation of donor flap, removing
visco-material from anterior chamber. Using the
modified PK were operated 165 patients (age 12-
79 years old) with single eye, complicated cornea
opacification, complicated aphakia, symblepharone
and others.
Results. In no case we had obtain any serious
complication, such as vitreous loss or expulsive
hemorrhage. The transparent corneal graft survival
took place in 90.3% (149 eyes). In 12 cases (7.3%)
with total vascular corneal opacification we observed
postoperatively mild corneal graft reaction
with light opacification and single corneal neovascularization.
In 4 patients we added additional suture
in 2 weeks after surgery. The improvement of
visual acuity was obtained in every patient (from h.m. to 0.1 – 0.5; from 0,06 to 0.1 – 0.7). Postoperative
care included standard local and general therapy
using corticosteroids during 6 months.
Conclusions. The open sky surgery is very
dangerous for the future functions of the eye. This
modification of PK allows us to avoid open sky moment
during operation and to save the eye from the development of dangerous complications of open
sky eye surgery. According to our experience, this
technique may be used as operation of choice in
the microsurgical treatment of complicated cases
of corneal diseases.
