Jatin Ashar1 1Mumbai Eye Care, Cornea and LASIK Centre

Slides:

Advertisements

Similar presentations

Normal Anterior Chamber Angle

Advertisements

Femtosecond Laser–Assisted Sutureless Anterior Lamellar Keratoplasty

Therapeutic Penetrating Keratoplasty in Fungal Keratitis: Prospective Study Sonika Gupta Consultant Ophthalmology Max Eye Care New Delhi, India Author.

Venting Incisions in DSAEK Patients: Is It an Absolute Necessity?

Use of a Novel Y- Suture Technique to Reduce Detachments in Descemet’s Stripping Automated Endothelial Keratoplasty (DSAEK) Habeeb Ahmad, MD Martin Heur,

The authors have no financial interests to disclose

Transplantation of Suboptimal Corneal Donor Tissue: A Case Series Elsie Chan, FRANZCO Graeme Pollock, PhD Rasik B. Vajpayee, FRANZCO World Cornea Congress,

Retrospective comparison of staged versus combined cataract surgery and Descemet’s-stripping endothelial keratoplasty (DSEK) in patients with Fuchs’ Dystrophy.

Early Outcomes of Descemet’s Stripping Automated Endothelial Keratoplasty in Pseudophakic Eyes with Anterior Chamber Intraocular Lenses Preeya K. Gupta.

Roy E Lehman MD*, Samuel F Fulcher MD**

Department of Ophthalmology, University Hospital Ayr, Scotland

CORNEAL SURGERY 1. Penetrating keratoplasty 2. Keratoprosthesis 3. Refractive surgery Radial keratotomy Photorefractive keratectomy (PRK) Laser in-situ.

DESCEMETIC DALK AND PREDESCEMETIC DALK : OUTCOMES IN 44 CASES DR. NITESH NARAYEN CORNEA AND REFRACTIVE SURGEON MAXIVISION HYDERABAD THE AUTHOR HAS NO FINANCIAL.

Dislocation of the DSEK Donor Graft into the Posterior Segment An Intraoperative Complication in DSEK Surgery Mark M Fernandez MD, Mark S Gorovoy MD, George.

Introduction To Corneal Transplantation

Partnerships for Success: Corneal Transplant in the 21st Century Breakout Session A Presenters: Christopher Blanton, MD Medical Director, Ocular Services,

Dr. K.S.SIDDHARTHAN Aravind Eye Hospital Coimbatore

Somasheila I. Murthy, Prashant Garg, Pravin K. Vaddavalli

Dept. of Ophthalmology, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany. Outcome after big-bubble deep anterior lamellar keratoplasty.

Retinal Detachment after Keratoprosthesis Placement: Incidence, Predisposing Factors, and Visual and Anatomic Outcomes M. Stephanie R. Jardeleza, M.D.

Urrets-Zavalia Syndrome Following Descemet Stripping Endothelial Keratoplasty Claire Y. Chu, MD Pawan Prasher, MD Eric Dai, MD R. Wayne Bowman, MD V. Vinod.

INTACS – PKP Comparison X X 180°-0.75 TransplantIntacs.

Glaucoma and Penetrating Keratoplasty : Incidence, Risk Factors, and Outcomes Sonika Gupta Consultant Ophthalmology Max Eye Care New Delhi, India Author.

Visual Outcomes After Temporary Keratoprosthesis Kristin C. Bains, MD Robert Phillips, MD The authors have no financial interest in the subject matter.

Visualization of Epithelial Downgrowth of Inferior Angle, Iris, and Corneal Endothelium With Means of Endolaser Probe Mahmoud A. Khaimi, MD J. Matthew.

Evaluation of Corneal Graft Profile Following Deep Anterior and Posterior Lamellar Keratoplasty Procedures by Fourier-Domain Optical Coherence Tomography.

Anterior Segment Optical Coherence Tomography and In Vivo Confocal Microscopy Findings in Femtosecond Laser- Assisted Keratoplasty Kurt H. Kelley, MD;

Case Report of Severe Haze After DSAEK

Indications for and Outcomes of Therapeutic Penetrating Keratoplasty Sonika Gupta Consultant Ophthalmology Max Eye Care New Delhi, India Author has no.

Descemet Stripping Automated Endothelial Keratoplasty in patients with Toxic anterior segment syndrome induced endothelial failure First and Presenting.

“Tuck In” Lamellar Keratoplasty (TILK) for Post-Keratoplasty Corneal Ectasia involving the Corneal Periphery Vishal Jhanji, MD 1,2 Jacqueline Beltz, MBBS,

1 Clinical Outcomes of DSEK Surgery Combined With Other Intraocular Procedures Neil Mahesh Vyas, MD Fei Yu, PhD Anthony J. Aldave, MD Sophie Deng, MD,

Endothelial Keratoplasty in Patients With an Anterior Chamber Intraocular Lens: A Montreal Experience Georges M. Durr, MD 1,2 Johanna Choremis, MD, FRCSC.

Clinical outcome of DALK in Keratoconus – A one year follow up

E-Poster Price Vision Group & Cornea Research Foundation of America Descemet - Stripping Endothelial Keratoplasty :Survival Outcomes in Eyes with Pre-

Descemet Stripping Automated Endothelial Keratoplasty with a Graft Insertion Device : Technique and Early Results Dr Wei-Boon KHOR, MRCS(Ed), Dr Jodhbir.

Urrets-Zavalia Syndrome After Lamellar Corneal Transplant: Two Case Reports Timothy Y. Chou, MD, Sujata P. Prabhu, MD, Justin Dexter, MD Department of.

J. Brian Foster, MD No Financial Disclosures

Risk Factors and Outcomes of Donor Lenticule Dislocation Following DSEK Pravin K Vaddavalli MD, Suntia Chaurasia MD, Muralidhar Ramappa MD, Prashant Garg.

Deep Anterior Lamellar Keratoplasty (DALK) Vs Penetrating Keratoplasty (PK) in patients with Keratoconus (KC). Dr. K.S.SIDDHARTHAN Aravind Eye Hospital.

Jodhbir S Mehta, Donald Tan The Authors have a financial Interest in the Endoglide patent/royalty.

Etiological and decision making factors for repeat DSAEK or PK in cases of failed Descemet stripping automated endothelial keratoplasty First and Presenting.

Mushroom shaped wound configurized penetrating keratoplasty and its customized modifications Hong Kyun Kim 1, Sang Hee Lee 2, Won Mun Seo 1. Sun Hwa Chai.

DSEK for the treatment of endothelial disease in India -Initial Experience in 80 eyes- Authors have no financial interest Dr Ashish Nagpal MD, FRCS Dr.

Comparison of Endothelial Keratoplasty (EK) Visual Outcomes with OCT Derived Corneal Thickness Measurements Authors Abraham K. Sleem, MD Robert L. Schultze,

Dorota Tarnawska, MD Dariusz Dobrowolski, MD Dominika Janiszewska

Descemet’s stripping automated endothelial keratoplasty by novice endothelial keratoplasty surgeons Jason W. Much, M.D. 1 Paul M. Phillips, M.D. 1,2 Leslie.

EXPERIENCE WITH A PMMA KERATOPROSTHESIS AT THE FEDERAL UNIVERSITY OF SAO PAULO, BRASIL Oliveira LA, M.D; Sousa LB, M.D; Hofling-Lima AL, M.D; Freitas D,

Descemet’s Stripping Endothelial Keratoplasty (DSEK) in patients with prior Trabeculectomy or Tube shunt surgery. Thadani S.M. Fynn-Thompson N. Authors.

John P Berdahl M.D.* David R. Hardten M.D., F.A.C.S.* *No relevant financial disclosures.

Management of corneal perforations and deep ulcers with patch grafts Dariusz Dobrowolski¹, Edward Wylęgała¹ ׳ ², Dorota Tarnawska¹, Dominika Janiszewska¹.

Outcomes of Descemet Stripping Automated Endothelial Keratoplasty in patients with a Pre-Existing Anterior Chamber Intraocular Lens S. Elderkin1A, E. Tu1A,

Mumbaieyecarecornealasik.com.

Outcomes and Complications of DSEK in Eyes with Tube shunts or ACIOLs

World Cornea Congress VI April 7-9, 2010

Special considerations for DSEK in monocameral eyes

Endothelial keratoplasty for failed penetrating keratoplasty grafts

DSAEK using corneas with previous LASIK

Endothelial keratoplasty in failed grafts

Kyoto Prefectural University of Medicine

Early Experience with Descemet’s Stripping Automated Endothelial Keratoplasty Combined with Phacoemulsification: Clinical and Refractive Outcome University.

Hong A, Boehlke CS, Afshari NA, Kim T Duke University Medical Center

Clinical study of open angle glaucoma surgery treatment trough deep slerectomy with T-Flux NV implant: three years follow-up Dr. Marco Rossi Dr Michele.

Amit Patel, FRCOphth Massimo Busin, MD

Glaucoma Progression after Descemet’s Stripping Endothelial Keratoplasty Neelofar Ghaznawi MD, Melissa B Daluvoy MD, Ajoy Virdi MD, Edwin S Chen, Kristin.

Role of HSV Infection in the Histopathology of Failed DSAEK

Jonathan M. Davidorf, MD Los Angeles, CA ASCRS Annual Meeting

Anand K Shah MD1 Neda Shamie MD1 Paul Phillips MD1 Mark A Terry MD1,2*

Matthew Caldwell, Alan Proia, Francis DeCroos, and Natalie Afshari

Presentation transcript:

Management of Failed Penetrating Keratoplasty: A New OCT-Based Protocol Jatin Ashar1 1Mumbai Eye Care, Cornea and LASIK Centre 1The Perfect Vision Laser LASIK Centre NO FINANCIAL DISCLOSURES

Introduction Management options for failed penetrating keratoplasty include repeat penetrating keratoplasty, Descemet’s stripping endothelial keratoplasty or keratoprosthesis Management of failed penetrating keratoplasty is technically challenging and numerous issues have to be addressed related to the type of surgery, prediction of surgical surprises, graft size and need of additional surgery A pre operative evaluation using anterior segment OCT may help in avoiding complications and improving outcomes

Purpose Material & Methods To evaluate the role of Anterior OCT in management of failed graft 440 graft host sections of 55 failed grafts were analyzed using AS-OCT(Visante, Carl Zeiss, Germany) Malapposition were categorized as gapes, graft or host steps, ledge, protrusion hills or tags Material & Methods

Results Smooth posterior graft host junction (3) allowed larger or same size DSEK/PK graft Anterior malapposition(3) necessitated repeat PK Irregular posterior wound malaaposition 17 cases (2 step, 1 protrusion, 1 gap, 13 ledge) needed larger PK/ smaller DSEK graft Extensive synechiae >180 degrees in 3 cases and less than 180 degrees synechiae were noted in 4 cases

Graft Sizing Graft size same as previous graft Case 1: 60/M Keratoplasty for corneal scar 4 years back Graft failure secondary to graft rejection Plan: Repeat keratoplasty Case 2: 71/F Keratoplasty Graft failure Plan: Repeat keratoplasty

Graft Sizing Graft size smaller than previous graft 32/F Operated large PK 8 months back, Failed graft with PED

67/M Operated PK followed by cataract surgery elsewhere Graft larger than previous PK

Conclusion AS OCT provides useful information about the graft host junction and anterior chamber structures after PK that may be useful in anticipation of problems during repeat surgery (DSEK/PK) (need for synechiolysis, available space in the anterior chamber for DSEK, glaucoma device placement and need for glaucoma surgery), graft sizing (step, ledge configurations- smaller/same sized DSEK graft, smooth configuration- larger sized DSEK graft)/ malapposed posterior wound –avoid smaller repeat graft