mall, overlapping tectonic keratoplaty involving graft–hot junction of penetrating keratoplaty

PURPOE: To report the indication for and potoperative coure of mall tectonic keratoplatie overlapping (and involving) the graft–hot junction of preexiting penetrating keratoplatie. METHOD: A retropective tudy of 15 conecutive eye (15 patient) with mall tectonic keratoplatie overlapping the graft–hot junction of preexiting penetrating keratoplatie. REULT: After tectonic keratoplaty, follow-up time ranged from 5 month to 20 year (mean, 69 month). Clinical indication included terile corneal ulceration (even cae), bacterial keratiti (ix cae), and fungal keratiti (two cae). In the ix cae with bacterial keratiti, five were uture abcee, with four reulting in wound dehicence. Ten tectonic graft were lamellar keratoplatie, and five were penetrating keratoplatie. Potoperative bet-corrected viual acuitie were unchanged from preoperative level in every patient. After tectonic grafting, the mean ± D change in keratometric atigmatim in the parent penetrating keratoplaty wa 1.75 ± 1.50 diopter. The atigmatim increaed in 10 cae, decreaed in three, and remained unchanged in two. There wa no cae of recurrent ulceration or wound dehicence in or around the tectonic graft. The urgery did not reult in new glaucoma or worening of preexiting glaucoma. CONCLUION: In the treatment of infectiou or ulcerative foci at or near the graft–hot junction of penetrating keratoplatie, a mall extirpative, tectonic graft over the dieaed junction appear to be a afe and effective alternative to either repeating the original penetrating keratoplaty or performing an overize tranplant