Avtor/Urednik		Morela, Vesna; Mikek, Kristina
Naslov		Keratoplastika pri keratokonusu
Prevedeni naslov		The results of penetrating keratoplasty for keratoconus
Tip		članek
Vir		Zdrav Vestn
Vol. in št.		Letnik 71, št. Suppl 2
Leto izdaje		2002
Obseg		str. II-39-41
Jezik		slo
Abstrakt		Background. To evaluate etiology, indications, results and complication rates associated with corneal transplantation for keratoconus. Methods. In this retrospective clinical study, 101 eyes of 79 patients had corneal transplantation. Mean age at surgery was 30.5 years. Follow up period was 2 to 25 yrs. All surgeries were performed by one surgeon. Candidate for surgery were patients who cannot tolerate contact lenses or are not adequately visually rehabilitated by them. Before surgery the best corrected visual acuity was 0.05 to 0.3 in 27%; 73% of patients had uncorrected visual acuity hand movement or counting fingers. Results. Best corrected visual acuity postoperatively was in 72% of patients 0.5 to 1.0 and in 26% 0.4 to 0.1. 2% of patients had visual acuity less than 0.1. In all cases we had postkeratoplasty astigmatism of 2.5+-4.75 Cyl with or without residual myopia. The most often postoperative complication was graft rejection (10%) which was successfully treated with medications. Unsuccessfull rate was 3%. Conclusions. The improved results, low complication rate, and postoperative enhancement management indicate that corneal trensplantation is a viable option in the clinical course of keratoconus. The optimal visual acuity postoperatively is achieved with contact lens, which correct postoperative astigmatism and myopia. Improvements in refractive surgery can help manage with postkeratoplasty astigmatism and myopia.
Izvleček		Izhodišča. V članku predstavimo etiologijo in indikacije za operativno zdravljenje keratokonusa s penetrantno keratoplastiko. Metode. V retrospektivni klinični študiji smo obdelali 101 bolnika s keratokonusom, pri katerih je bila narejena penetrantna keratoplastika. Čas sledenja bolnikov je bil od 2 do 25 let. Operiral je en sam kirurg. Povprečna starost bolnikov je bila 30,5 leta. Indikacije za operacijo so bile slab vid s kontaktno lečo ali neprenašanje kontaktnih leč. Pred operacijo je bila vidna ostrina s kontaktno lečo pri 27% bolnikov od 0,05 do 0,3; v 73% pa gib roke pod očesom. Rezultati. Vidna ostrina s korekcijo po operaciji je bila v 72% primerov od 0,5 do 1,0; v 26% 0,4 do 0,1. Manj kot 0,1 pa je videlo 2% bolnikov. Pri vseh transplantirancih ostane astigmatizem od 2,5+-4,75Cyl z miopijo ali brez. Med pooperativnimi zapleti je bila najpogostejša zavrnitvena reakcija (10%). V 3% primerov konzervativno zdravljenje ni bilo uspešno. Zaključki. Penetrantna keratoplastika pri keratokonusu izboljša vidno ostrino. Pooperativni zapleti so redki in večinoma dobro obvladljivi s konzervativnim zdravljenjem. Po penetrantni keratoplastiki vedno ostane pooperativni astigmatizem, ki ga uspešno korigiramo s kontaktno lečo. Korekcija astigmatizma in kratkovidnosti, ki ostaja po operaciji, napoveduje razvoj refraktivne kirurgije.
Deskriptorji		KERATOCONUS KERATOPLASTY, PENETRATING TREATMENT OUTCOME