Oversized corneal grafts for corneal opacities with iridocorneal adhesions

Objective: To evaluate the efficacy of 1-mm, oversized: corneal grafts in p atients with acquired corneal opacities and extensive peripheral iridocorne al adhesions. Design: Prospective noncomparative. case series. Participants. Twenty patients (20 eyes), aged 15 years or older with unilat eral or bilateral: corneal opacification and a shallow anterior chamber. Intervention: Penetrating. keratoplasty was performed with donor corneal bu ttons oversized by 1 mm. Main Outcome Measures; The various parameters evaluated were visual acuity, graft clarity, keratometry, anterior chamber depth, intraocular pressure, and spherical equivalent refraction 12 months after surgery. Results. The keratoplasties were performed. in 15 eyes with a corneo-iridic scar after infectious keratitis (75%) and 5 eyes with failed graft (25%). At the final follow-up, a clear graft was achieved in 17 eyes (85%), and 14 eyes (70%) achieved a best-corrected visual acuity of 6/12 or better. Thre e of the grafts failed because of rejection., The average keratometry was 4 4.1 +/-1.0 diopters (D), and the mean spherical equivalent was -3.23 +/-2.8 6 D. The oversized grafts provided a mean anterior chamber depth of 2.36 +/ -0.42 mm, and the mean intraocular pressure, at, the 1.2 month follow-up wa s 16.38 +/-2.09 mmHg. Conclusions: Corneal grafts oversized by 1 mm provide adequate anterior cha mber depth and reduce the risk of peripheral anterior synechiae and seconda ry glaucoma in patients with corneal opacities and extensive peripheral iri docorneal adhesions. Ophthalmology 2001;108:2026-2028 (C) 2001 by the Ameri can Academy of Ophthalmology.