Modern modifications of penetrating keratoplasty with complex operative incision

Trufanov S.V.; Budnikova E.A.; Rozinova V.N.

doi:https://doi.org/10.17116/oftalma2019135052260

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Abstract:

The basic principle of modern keratoplasty is selectivity, i.e. the choice of whether to replace only the affected corneal layer. However, when layer-by-layer and interlayer transplantation is not indicated, the method of choice is conventional penetrating keratoplasty. An alternative can be its modifications with complex profiles of the transplant edges and the bed, which are better justified in terms of pathogenesis. The most popular among them are mushroom, zig-zag and top-hat. These surgeries combine optical benefits of penetrating keratoplasty as they do not involve dissection of the corneal optical zone and can negate — to a certain degree — its main downsides such as low trauma tolerance of the postoperative scar, significant level of postoperative astigmatism, and increased visual rehabilitation time. Mushroom-shaped incisions can be performed manually with a femtosecond laser or a microkeratome, zig-zag incision — only with a femtosecond laser. Considering the diversity of keratoplasty modifications with complex operative incisions, further research is required for evaluation of their clinical effectiveness and analysis of postoperative complications.

Keywords:

mushroom keratoplasty

top-hat keratoplasty

zig-zag keratoplasty

complex operative incision

stepped incision

Authors:

Trufanov S.V.

Uchrezhdenie Rossiĭskoĭ akademii meditsinskikh nauk "NII glaznykh bolezneĭ RAMN", Moskva

SPIN RSCI: 1603-8931
Scopus AuthorID: 6508163770
ORCID: 0000-0003-4360-793X

Budnikova E.A.

Research Institute of Eye Diseases, 11A Rossolimo St., Moscow, Russian Federation, 119021

ORCID: 0000-0001-7721-7652

Rozinova V.N.

Research Institute of Eye Diseases, 11 A, B, Rossolimo St., Moscow, Russian Federation, 119021

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References:

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