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Ring-shaped corneoscleral lamellar keratoplasty guided by high-definition optical coherence tomography and Scheimpflug imaging for severe Terrien’s marginal corneal degeneration

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Abstract

Background

To evaluate the clinical efficacy of ring-shaped corneoscleral lamellar keratoplasty under guidance of high-definition optical coherence tomography (HD-OCT) and Scheimpflug imaging for severe Terrien’s marginal corneal degeneration.

Methods

Twenty-five patients (25 eyes) with Terrien's marginal corneal degeneration and ≥ 6 diopters of astigmatism were treated at the Shandong Eye Institute from January 2008 through December 2010. In these patients, the diseased area was > 1 quarter of the cornea, and the thickness at the thinnest corneal area was < 150 μm with residual corneal stroma. Ring-shaped corneoscleral lamellar keratoplasty was performed, and the depth and width of dissection was set according to the HD-OCT and Pentacam examinations. Data of complications, surgical effects, visual acuity, and astigmatism were collected.

Results

No intraoperative corneal perforation occurred. No patients had liquid accumulation between the graft and the recipient. At 1 year after surgery, the average best-corrected visual acuity improved to 6/9 from preoperative 6/36, and the average astigmatism reduced to 4.37 (2.04) diopters from preoperative 13.39 (7.52) diopters. There was no recurrence of the disease or corneal graft rejection in the follow-up period.

Conclusions

Ring-shaped corneoscleral lamellar keratoplasty guided by HD-OCT and Pentacam imaging appears to be effective in the treatment of severe Terrien’s marginal corneal degeneration. Surgical perforation can be significantly reduced.

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Acknowledgments

This study was supported by the National Natural Science Foundation of China (30872817), the Taishan Scholar Program of Shandong Province (20081148), and the Natural Science Foundation of Shandong Province (ZR2010HQ011). The authors thank Ms. Ping Lin for her editorial assistance.

Conflict of interest

None.

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Authors and Affiliations

  1. Qingdao University Medical College, Qingdao, China

    Ting Wang

  2. Shandong Eye Hospital, Shandong Eye Institute, Shandong Academy of Medical Sciences, 5 Yanerdao Road, Qingdao, 266071, People’s Republic of China

    Ting Wang, Weiyun Shi, Gang Ding, Suxia Li, Mingna Liu & Hua Gao

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  1. Ting Wang
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  2. Weiyun Shi
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  3. Gang Ding
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  4. Suxia Li
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  5. Mingna Liu
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  6. Hua Gao
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Correspondence to Weiyun Shi.

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Wang, T., Shi, W., Ding, G. et al. Ring-shaped corneoscleral lamellar keratoplasty guided by high-definition optical coherence tomography and Scheimpflug imaging for severe Terrien’s marginal corneal degeneration. Graefes Arch Clin Exp Ophthalmol 250, 1795–1801 (2012). https://doi.org/10.1007/s00417-012-2042-4

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  • DOI: https://doi.org/10.1007/s00417-012-2042-4

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