RESULTS OF PENETRATING KERATOPLASTY IN BULLOUS SILICONE OIL KERATOPATHY

Background: To evaluate the results of penetrating keratoplasty (PK) i n bullous silicone oil keratopathy (BSK). Material and methods: PK for BSK was performed in 13 patients, aged from 31 to 82 years. In all pa tients, pars plana vitrectomy (PPV) with silicone oil implantation (SO I) had been previously performed as the definitive surgery: for compli cated retinal detachment with advanced proliferative vitreoretinopathy in 13 eyes and for diabetic traction detachment in one eye. Seven pat ients were monocular. All 13 eyes were aphakic and there was a long-la sting contact of silicone oil with the corneal endothelium. Before ker atoplasty, each eye underwent between two and five operations, on aver age three, for retinal detachment or late complications of SOI. The in terval between SOI and PK was from 11 to 79 months. The patients were followed up for 12-52 months. Results: At the last follow-up examinati on, a clear graft was found in 6 out of 13 eyes (46%). The six clear g rafts were found in the ten eyes where silicone oil had been removed b efore keratoplasty. The graft became opaque in all three eyes in which silicone oil had not been removed. Six out of seven eyes with failed grafts atrophied. Visual acuity improved in all six eyes with the clea r graft from had movement preoperatively to 0.05-0.25. The decreased v isual acuity was caused by irreparable damage to the macula, which res ulted from high myopia, proliferative vitreoretinopathy or long-lastin g detachment of the macula. Conclusions: PK in BSK was successful only in those eyes in which the attached retina enabled the removal of the silicone oil before the PK. The reattached retina and useful visual a cuity before the development of BSK were the preconditions for functio nal success of the PK.