Ipsilateral rotational autokeratoplasty - An alternative to penetrating keratoplasty in nonprogressive central corneal scars

Purpose. To report the outcome of ipsilateral rotational autokeratoplasty p erformed for nonprogressive central corneal opacities. Methods. Medical rec ords of 27 patients who underwent ipsilateral rotational autokeratoplasty b etween June 1995 and December 1998 were retrospectively reviewed. The etiol ogy of corneal opacity, preoperative visual acuity, and size of the trephin e used was noted. Any intraoperative and early and late postoperative compl ications were noted in all patients. The final outcome, visual acuity, and astigmatism at final correction were analyzed. Results. The main etiology o f corneal opacity was trauma (44.4%), followed by resolved keratitis (29.6% ). The size of the graft ranged from 6.5 to 9 mm. Fifteen patients underwen t autokeratoplasty alone; additional procedures were combined in the remain ing 12. Wound leak was the most common postoperative complication, which wa s seen in seven patients. The mean follow-up was 12.11 months (SD = 11.95 m onths). Five patients (18.5%) were lost to follow-up. Of the remaining 22, 19 (86.36%) had clear grafts and 3 (13.6%) had failed grafts. The mean asti gmatism at final correction was 4.25 diopters cylinder(SD = 2.72). Final vi sual acuity of 20/80 or better was obtained in 13 cases (59.09%). Conclusio ns. Contrary to common belief, ipsilateral rotational autokeratoplasty is a safe and effective surgical procedure. It can be considered as an alternat ive procedure to penetrating keratoplasty in a scenario in which tissue sca rcity exists, as well as in cases that have a high risk of developing immun ologic allograft rejection. Further prospective studies with preoperative s pecular microscopy and postoperative corneal topography will provide greate r insight into the usefulness of this procedure.