cornea-keratoplasty Flashcards
What are the indications of keratoplasty?
Optical- improve vision. For corneal opacity, bullous keratoplasty, corneal dystrophies, advanced keratoconus.
Therapeutic- replace inflamed cornea not responding to conventional therapy.
Tectonic graft- restore integrity of eyeball. After corneal perf or marked corneal thinning.
Cosmetic- improve appearance of eye
What are the types of keratoplasty?
Auto keratoplasty- rotational and contralateral.
Allokeratoplasty- penetrating k. Lamellar k Deep anterior lamellar k Descemets stripping endothelial k Small patch graft
How do you evaluate donor cornea?
Bio microscopic exam of whole globe
Before processing is imp.
Graded into excellent very good good fair poor
Depends on condition of corneal epithelium, stroma, descemets membrane and endothelium.
What are the methods of corneal preservation?
Short term- up to 48 hrs. Globe kept at 4C in moist chamber.
Intermediate- upto 2 weeks.
Cornea kept in mccareys-Kaufman medium and various chondroitin dilate enriched media- optisol medium.
Long term- upto 35 days.
Done by organ culture method or cryopreservation at -70C
Complications of corneal keratoplasty?
Early- flat anterior chamber
Iris prolapse, infection, secondary glaucoma, epithelial defects.
Late- graft rejection, recurrence of disease and astigmatism.
