Corneal transplantation for keratoconus

Authors

  • Sven Jonuscheit
  • Michael J Doughty Vision Sciences, Department of Life Sciences, Glasgow Caledonian University, Cowcaddens Road, Glasgow, G4 0BA, UK

DOI:

https://doi.org/10.5384/sjovs.vol5i2p

Keywords:

Cornea, corneal transplantation, keratoconus, penetrating keratoplasty, deep anterior lamellar keratoplasty, endothelium

Abstract

This review discusses current techniques of corneal transplantation for moderate to advanced keratoconus. The aim of this article is to provide primary eye care practitioners with an overview of two current corneal transplantation modalities, namely penetrating and deep anterior lamellar keratoplasty. The main surgical techniques, the outcome of the procedures, common complications and the prognosis will be reviewed. Results from ongoing studies at a corneal transplant centre in Glasgow, Scotland will be discussed.

 

Metrics

Metrics Loading ...

Author Biographies

Sven Jonuscheit

Lecturer in Vision Sciences

Programme Leader

Vision Sciences, Department of Life Sciences, Glasgow Caledonian University, Cowcaddens Road, Glasgow, G4 0BA, UK

Michael J Doughty, Vision Sciences, Department of Life Sciences, Glasgow Caledonian University, Cowcaddens Road, Glasgow, G4 0BA, UK

Vision Sciences, Department of Life Sciences, Glasgow Caledonian University, Cowcaddens Road, Glasgow, G4 0BA, UK

References

Abbott, R. L., Fine, M., & Guillet, E. (1983). Long-term changes in corneal endothelium following penetrating keratoplasty. A specular microscopic study. Ophthalmology, 90(6), 676-685.

Al-Torbak, A. A., Al-Motowa, S., Al-Assiri, A., Al-Kharashi, S., Al-Shahwan, S., Al-Mezaine, H., et al. (2006). Deep anterior lamellar keratoplasty for keratoconus. Cornea, 25(4), 408-412.

Anshu, A., Lim, L. S., Htoon, H. M., & Tan, D. T. (2011). Postoperative risk factors influencing corneal graft survival in the Singapore Corneal Transplant Study. Am J Ophthalmol, 151(3), 442-448 e441.

Anwar, M., & Teichmann, K. D. (2002). Deep lamellar keratoplasty: surgical techniques for anterior lamellar keratoplasty with and without baring of Descemet's membrane. Cornea, 21(4), 374-383.

Armitage, W. J. (2011). Preservation of Human Cornea. Transfus Med Hemother, 38(2), 143-147.

Armitage, W. J., Dick, A. D., & Bourne, W. M. (2003). Predicting endothelial cell loss and long-term corneal graft survival. Invest Ophthalmol Vis Sci, 44(8), 3326-3331.

Awan, M. A., Roberts, F., Hegarty, B., & Ramaesh, K. (2010). The outcome of deep anterior lamellar keratoplasty in herpes simplex virus-related corneal scarring, complications and graft survival. Br J Ophthalmol, 94(10), 1300-1303.

Balasubramanian, S. A., Mohan, S., Pye, D. C., & Willcox, M. D. (2012). Proteases, proteolysis and inflammatory molecules in the tears of people with keratoconus. Acta Ophthalmol, 90(4), e303-309.

Basak, S. K. (2004). Low endothelial cell count and clear corneal grafts. Indian J Ophthalmol, 52(2), 151-153.

Beckingsale, P., Mavrikakis, I., Al-Yousuf, N., Mavrikakis, E., & Daya, S. M. (2006). Penetrating keratoplasty: outcomes from a corneal unit compared to national data. Br J Ophthalmol, 90(6), 728-731.

Borderie, V. M., Boelle, P. Y., Touzeau, O., Allouch, C., Boutboul, S., & Laroche, L. (2009). Predicted long-term outcome of corneal transplantation. Ophthalmology, 116(12), 2354-2360.

Borderie, V. M., Sandali, O., Bullet, J., Gaujoux, T., Touzeau, O., & Laroche, L. (2012). Long-term results of deep anterior lamellar versus penetrating keratoplasty. Ophthalmology, 119(2), 249-255.

Bourne, W. M. (2001). Cellular changes in transplanted human corneas. Cornea, 20(6), 560-569.

Castroviejo, R. (1948). Keratoplasty for the Treatment of Keratoconus. Trans Am Ophthalmol Soc, 46, 127-153.

Claesson, M., & Armitage, W. J. (2009). Ten-year follow-up of graft survival and visual outcome after penetrating keratoplasty in Sweden. Cornea, 28(10), 1124-1129.

Claesson, M., Armitage, W. J., Fagerholm, P., & Stenevi, U. (2002). Visual outcome in corneal grafts: a preliminary analysis of the Swedish Corneal Transplant Register. Br J Ophthalmol, 86(2), 174-180.

Coster, D. J., & Williams, K. A. (2005). The impact of corneal allograft rejection on the long-term outcome of corneal transplantation. Am J Ophthalmol, 140(6), 1112-1122.

Cristina Kenney, M., & Brown, D. J. (2003). The cascade hypothesis of keratoconus. Cont Lens Anterior Eye, 26(3), 139-146.

Doughty, M. J. (1989). Toward a quantitative analysis of corneal endothelial cell morphology: a review of techniques and their application. Optom Vis Sci, 66(9), 626-642.

Doughty, M. J., Jonuscheit, S., & Button, N. F. (2011). Assessment of the reliability of endothelial cell-density estimates in the presence of pseudoguttata. Graefes Arch Clin Exp Ophthalmol.

Doughty, M. J., Muller, A., & Zaman, M. L. (2000). Assessment of the reliability of human corneal endothelial cell-density estimates using a noncontact specular microscope. Cornea, 19(2), 148-158.

Edelhauser, H. F. (2006). The balance between corneal transparency and edema: the Proctor Lecture. Invest Ophthalmol Vis Sci, 47(5), 1754-1767.

Edwards, M., Clover, G. M., Brookes, N., Pendergrast, D., Chaulk, J., & McGhee, C. N. (2002). Indications for corneal transplantation in New Zealand: 1991-1999. Cornea, 21(2), 152-155.

Epstein, A. J., de Castro, T. N., Laibson, P. R., Cohen, E. J., & Rapuano, C. J. (2006). Risk factors for the first episode of

corneal graft rejection in keratoconus. Cornea, 25(9), 1005-1011.

Fagerholm, P., Claesson, M., & Stenevi, U. (2002). [Growing waiting list for corneal transplantation]. Lakartidningen, 99(5), 385-387.

Fontana, L., Parente, G., & Tassinari, G. (2007). Clinical outcomes after deep anterior lamellar keratoplasty using the big-bubble technique in patients with keratoconus. Am J Ophthalmol, 143(1), 117-124.

Han, D. C., Mehta, J. S., Por, Y. M., Htoon, H. M., & Tan, D. T. (2009). Comparison of outcomes of lamellar keratoplasty and penetrating keratoplasty in keratoconus. Am J Ophthalmol, 148(5), 744-751 e741.

Inoue, K., Amano, S., Oshika, T., & Tsuru, T. (2001). Risk factors for corneal graft failure and rejection in penetrating keratoplasty. Acta Ophthalmol Scand, 79(3), 251-255.

Inoue, K., Kimura, C., Amano, S., Oshika, T., & Tsuru, T. (2002). Corneal endothelial cell changes twenty years after penetrating keratoplasty. Jpn J Ophthalmol, 46(2), 189-192.

Jensen, L. B., Hjortdal, J., & Ehlers, N. (2010). Longterm follow-up of penetrating keratoplasty for keratoconus. Acta Ophthalmol, 88, 347-351.

Jones, M. N., Armitage, W. J., Ayliffe, W., Larkin, D. F., & Kaye, S. B. (2009). Penetrating and deep anterior lamellar keratoplasty for keratoconus: a comparison of graft outcomes in the United Kingdom. Invest Ophthalmol Vis Sci, 50(12), 5625-5629.

Jonuscheit, S., Doughty, M. J., & Ramaesh, K. (2011). In vivo confocal microscopy of the corneal endothelium: comparison of three morphometry methods after corneal transplantation. Eye (Lond), 25(9), 1130-1137.

Jonuscheit, S., Doughty, M. J., & Ramaesh, K. (2012a). Assessment of a variable frame (polygonal) method to estimate corneal endothelial cell counts after corneal transplantation. Eye (Lond), 26(6), 803-809.

Jonuscheit, S., Doughty, M. J., & Ramaesh, K. (2012b). The corneal endothelium after keratoplasty for keratoconus Clin Exp Optom, under review.

Keenan, T. D. L., Carley, F., Yeates, D., Jones, M. N. A., Rushton, S., & Goldacre, M. J. (2010). Trends in corneal graft surgery in the UK. Br J Ophthalmol, doi:10.1136/bjo.2010.182329.

Kelly, T. L., Williams, K. A., & Coster, D. J. (2011). Corneal transplantation for keratoconus: a registry study. Arch Ophthalmol, 129(6), 691-697.

Koay, P. Y., Lee, W. H., & Figueiredo, F. C. (2005). Opinions on risk factors and management of corneal graft rejection in the United kingdom. Cornea, 24(3), 292-296.

Koo, T. S., Finkelstein, E., Tan, D., & Mehta, J. S. (2011). Incremental cost-utility analysis of deep anterior lamellar keratoplasty compared with penetrating keratoplasty for the treatment of keratoconus. Am J Ophthalmol, 152(1), 40-47 e42.

Kus, M. M., Seitz, B., Langenbucher, A., & Naumann, G. O. (1999). Endothelium and pachymetry of clear corneal grafts 15 to 33 years after penetrating keratoplasty. Am J Ophthalmol, 127(5), 600-602.

Larkin, D. F., Mumford, L. L., & Jones, M. N. (2011). Centre-Specific Variation in Corneal Transplant Outcomes in the United Kingdom. Transplantation, 91(3), 354-359.

Lema, I., & Duran, J. A. (2005). Inflammatory molecules in the tears of patients with keratoconus. Ophthalmology, 112(4), 654-659.

Lim, L., Pesudovs, K., & Coster, D. J. (2000). Penetrating keratoplasty for keratoconus: visual outcome and success. Ophthalmology, 107(6), 1125-1131.

Lim, N., & Vogt, U. (2002). Characteristics and functional outcomes of 130 patients with keratoconus attending a specialist contact lens clinic. Eye (Lond), 16(1), 54-59.

Matsuda, M., & Bourne, W. M. (1985). Long-term morphologic changes in the endothelium of transplanted corneas. Arch Ophthalmol, 103(9), 1343-1346.

McCarey, B. E., Edelhauser, H. F., & Lynn, M. J. (2008). Review of corneal endothelial specular microscopy for FDA clinical trials of refractive procedures, surgical devices, and new intraocular drugs and solutions. Cornea, 27(1), 1-16.

Melles, G. R., Lander, F., Rietveld, F. J., Remeijer, L., Beekhuis, W. H., & Binder, P. S. (1999). A new surgical technique for deep stromal, anterior lamellar keratoplasty. Br J Ophthalmol, 83(3), 327-333.

Melles, G. R., Remeijer, L., Geerards, A. J., & Beekhuis, W. H. (2000). A quick surgical technique for deep, anterior lamellar keratoplasty using visco-dissection. Cornea, 19(4), 427-432.

Nielsen, K., Hjortdal, J., Pihlmann, M., & Corydon, T. J. (2012). Update on the keratoconus genetics. Acta Ophthalmol.

Oblak, E., Doughty, M. J., & Oblak, L. (2002). A semi-automated assessment of cell size and shape in monolayers, with optional adjustment for the cell-cell border width-application to human corneal endothelium. Tissue Cell, 34(4), 283-295.

Panda, A., Vanathi, M., Kumar, A., Dash, Y., & Priya, S. (2007). Corneal graft rejection. Surv Ophthalmol, 52(4), 375-396.

Patel, H. Y., Ormonde, S., Brookes, N. H., Moffatt, S. L., Sherwin, T., Pendergrast, D. G., et al. (2011). The New Zealand National Eye Bank: survival and visual outcome 1 year after penetrating keratoplasty. Cornea, 30(7), 760-764.

Patel, S. V. (2011). Graft survival after penetrating keratoplasty. Am J Ophthalmol, 151(3), 397-398.

Patel, S. V., Hodge, D. O., & Bourne, W. M. (2005). Corneal endothelium and postoperative outcomes 15 years after penetrating keratoplasty. Am J Ophthalmol, 139(2), 311-319.

Rabinowitz, Y. S. (1998). Keratoconus. Surv Ophthalmol, 42(4), 297-319.

Rahman, I., Carley, F., Hillarby, C., Brahma, A., & Tullo, A. B. (2009). Penetrating keratoplasty: indications, outcomes, and complications. Eye (Lond), 23(6), 1288-1294.

Reinhart, W. J., Musch, D. C., Jacobs, D. S., Lee, W. B., Kaufman, S. C., & Shtein, R. M. (2011). Deep anterior lamellar keratoplasty as an alternative to penetrating keratoplasty a report by the american academy of ophthalmology. Ophthalmology, 118(1), 209-218.

Roe, R. H., Lass, J. H., Brown, G. C., & Brown, M. M. (2008). The value-based medicine comparative effectiveness and cost-effectiveness of penetrating keratoplasty for keratoconus. Cornea, 27(9), 1001-1007.

Sarnicola, V., Toro, P., Gentile, D., & Hannush, S. B. (2010). Descemetic DALK and Predescemetic DALK: Outcomes in 236 Cases of Keratoconus. Cornea, 29, 53-59.

Sellami, D., Abid, S., Bouaouaja, G., Ben Amor, S., Kammoun, B., Masmoudi, M., et al. (2007). Epidemiology and risk factors for corneal graft rejection. Transplant Proc, 39(8), 2609-2611.

Smadja, D., Colin, J., Krueger, R. R., Mello, G. R., Gallois, A., Mortemousque, B., et al. (2012). Outcomes of deep anterior lamellar keratoplasty for keratoconus: learning curve and advantages of the big bubble technique. Cornea, 31(8), 859-863.

Sugita, J., & Kondo, J. (1997). Deep lamellar keratoplasty with complete removal of pathological stroma for vision improvement. Br J Ophthalmol, 81(3), 184-188.

Suzuki, H., & Minarcik, J. R. (2009). Images in clinical medicine. Keratoconus complicated by acute corneal hydrops. N Engl J Med, 361(16), e32.

Tan, D. T., Anshu, A., & Mehta, J. S. (2009). Paradigm shifts in corneal transplantation. Ann Acad Med Singapore, 38(4), 332-338.

Tan, D. T., Dart, J. K., Holland, E. J., & Kinoshita, S. (2012). Corneal transplantation. Lancet, 379(9827), 1749-1761.

Tham, V. M., & Abbott, R. L. (2002). Corneal graft rejection: recent updates. Int Ophthalmol Clin, 42(1), 105-113.

Ting, D. S., Sau, C. Y., Srinivasan, S., Ramaesh, K., Mantry, S., & Roberts, F. (2011). Changing trends in keratoplasty in the West of Scotland: a 10-year review. Br J Ophthalmol.

Ting, D. S., Sau, C. Y., Srinivasan, S., Ramaesh, K., Mantry, S., & Roberts, F. (2012). Changing trends in keratoplasty in the West of Scotland: a 10-year review. Br J Ophthalmol, 96(3), 405-408.

Vail, A., Gore, S. M., Bradley, B. A., Easty, D. L., Rogers, C. A., & Armitage, W. J. (1997). Conclusions of the corneal transplant follow up study. Collaborating Surgeons. Br J Ophthalmol, 81(8), 631-636.

van den Biggelaar, F. J., Cheng, Y. Y., Nuijts, R. M., Schouten, J. S., Wijdh, R. J., Pels, E., et al. (2011). Economic evaluation of deep anterior lamellar keratoplasty versus penetrating keratoplasty in The Netherlands. Am J Ophthalmol, 151(3), 449-459 e442.

von Hippel, A. (1888). Eine neue Methode der Hornhauttransplantation. Graefes Arch Clin Exp Ophthalmol, 34(1), 108-130.

Wagoner, M. D., Ba-Abbad, R., Al-Mohaimeed, M., Al-Swailem, S., & Zimmerman, M. B. (2009). Postoperative complications after primary adult optical penetrating keratoplasty: prevalence and impact on graft survival. Cornea, 28(4), 385-394.

Williams, K. A., Kelly, T. L., Lowe, M. T., & Coster, D. J. (2010). The influence of rejection episodes in recipients of bilateral corneal grafts. Am J Transplant, 10(4), 921-930.

Zirm, E. (1906). Eine erfolgreiche totale Keratoplastik. Graefes Arch Clin Exp Ophthalmol, 64(3), 580-593.

Downloads

Published

2013-07-20

How to Cite

Jonuscheit, S., & Doughty, M. J. (2013). Corneal transplantation for keratoconus. Scandinavian Journal of Optometry and Visual Science, 6(1), 1–8. https://doi.org/10.5384/sjovs.vol5i2p

Issue

Section

Review Article